Provider Demographics
NPI:1245293430
Name:WINTER, MICHAEL W (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:W
Last Name:WINTER
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 1:11311 LA MIRADA BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90604-2126
Mailing Address - Country:US
Mailing Address - Phone:562-941-8218
Mailing Address - Fax:562-941-1809
Practice Address - Street 1:11311 LA MIRADA BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90604-2126
Practice Address - Country:US
Practice Address - Phone:562-941-8218
Practice Address - Fax:562-941-1809
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA334071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice