Provider Demographics
NPI:1801989744
Name:MICHAELS, GEORGE JOHN (DDS)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:JOHN
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 1:868 MYRTLE ST NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-1449
Mailing Address - Country:US
Mailing Address - Phone:404-607-1233
Mailing Address - Fax:
Practice Address - Street 1:845 SPRING ST NW
Practice Address - Street 2:UNIT B-1
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-1040
Practice Address - Country:US
Practice Address - Phone:404-685-3100
Practice Address - Fax:404-685-3031
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADNO105011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice