Provider Demographics
NPI:1194349407
Name:MICHELAKIS AND ASSOCIATES PA
Entity type:Organization
Organization Name:MICHELAKIS AND ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:MICHELAKIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:910-408-1885
Mailing Address - Street 1:1132 NEW POINTE BLVD STE 4
Mailing Address - Street 2:
Mailing Address - City:LELAND
Mailing Address - State:NC
Mailing Address - Zip Code:28451-4257
Mailing Address - Country:US
Mailing Address - Phone:910-408-1885
Mailing Address - Fax:910-408-1886
Practice Address - Street 1:1132 NEW POINTE BLVD STE 4
Practice Address - Street 2:
Practice Address - City:LELAND
Practice Address - State:NC
Practice Address - Zip Code:28451-4257
Practice Address - Country:US
Practice Address - Phone:910-408-1885
Practice Address - Fax:910-408-1886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-02
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental