DR. Michelle Gonzales Slade

NPI #1659918514 in Lake Forest, California

Provider Information

NPI Number: 1659918514
Entity Type: Individual
Name: DR. Michelle Gonzales Slade
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Enumeration Date: Dec 10, 2019
Last Updated: Dec 10, 2019

Practice Location

Address: 22111 TIMBERLINE WAY
City: Lake Forest
State: California
ZIP Code: 92630-3431
Phone: (714) 300-8526

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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