Provider Demographics
NPI:1760488803
Name:MICHAELS, ALAN H (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:H
Last Name:MICHAELS
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 1:9015 WOODYARD RD
Mailing Address - Street 2:STE 104
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-4226
Mailing Address - Country:US
Mailing Address - Phone:301-868-0777
Mailing Address - Fax:301-868-3660
Practice Address - Street 1:9015 WOODYARD RD
Practice Address - Street 2:STE 104
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-4226
Practice Address - Country:US
Practice Address - Phone:301-868-0777
Practice Address - Fax:301-868-3660
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD62771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice