Provider Demographics
NPI:1689742553
Name:MIKHAIL, SONIA BOTROS (DDS)
Entity Type:Individual
Prefix:DR
First Name:SONIA
Middle Name:BOTROS
Last Name:MIKHAIL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1860 N TRAVERSE AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93619-9597
Mailing Address - Country:US
Mailing Address - Phone:559-346-8486
Mailing Address - Fax:559-323-7319
Practice Address - Street 1:7455 N FRESNO ST STE 201
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2481
Practice Address - Country:US
Practice Address - Phone:559-256-2627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50956122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist