Individual
DR. MICHAEL AARON ELISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3656 WASHINGTON PARKWAY, IDAHO FALLS, ID 83404
(208) 522-7216
(208) 524-3851
Mailing address
3656 WASHINGTON PARKWAY, IDAHO FALLS, ID 83404
(208) 522-7216
(208) 524-3851
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D3605
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
80638000
—
ID
Enumeration date
06/30/2006
Last updated
07/08/2007
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