Provider Demographics
NPI:1447566823
Name:MICHELS, PAUL JEFFREY (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:JEFFREY
Last Name:MICHELS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8881 FLETCHER PKWY
Mailing Address - Street 2:SUITE 325
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-3134
Mailing Address - Country:US
Mailing Address - Phone:619-697-2800
Mailing Address - Fax:619-697-3754
Practice Address - Street 1:8881 FLETCHER PKWY
Practice Address - Street 2:SUITE 325
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-3134
Practice Address - Country:US
Practice Address - Phone:619-697-2800
Practice Address - Fax:619-697-3754
Is Sole Proprietor?:No
Enumeration Date:2010-08-24
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA584801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice