Provider Demographics
NPI:1932327566
Name:GEORGES, MICHAEL JOE (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOE
Last Name:GEORGES
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 1:2657 WINDMILL PKWY
Mailing Address - Street 2:#350
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-3384
Mailing Address - Country:US
Mailing Address - Phone:702-283-4569
Mailing Address - Fax:
Practice Address - Street 1:3225B S RAINBOW BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-6240
Practice Address - Country:US
Practice Address - Phone:702-877-1812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2266122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist