Individual
DR. MICHAEL JOSEPH CARLISLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
10801 BLONDO STREET, SUITE D, OMAHA, NE 68164-3800
(402) 493-9361
Mailing address
10801 BLONDO STREET, SUITE D, OMAHA, NE 68164-3800
(402) 493-9361
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5842
NE
Other
Enumeration date
10/16/2009
Last updated
06/04/2012
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