Provider Demographics
NPI:1801105234
Name:RAAD, MICHEL (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHEL
Middle Name:
Last Name:RAAD
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 1:101 PARK PL STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-1753
Mailing Address - Country:US
Mailing Address - Phone:925-922-4633
Mailing Address - Fax:
Practice Address - Street 1:101 PARK PL STE 200
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-1753
Practice Address - Country:US
Practice Address - Phone:925-922-4633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-04
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA604501223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics