Organization
DENNIS MICHAELSON D.M.D., MS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DENNIS J MICHAELSON D.M.D., M.S. (OWNER)
(208) 678-3265
Entity
Organization
Contact information
Practice address
2271 OVERLAND AVE STE 4, BURLEY, ID 83318-2957
(208) 678-3265
(208) 678-5206
Mailing address
2271 OVERLAND AVE STE 4, BURLEY, ID 83318-2957
(208) 678-3265
(208) 678-5206
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
67D1497
ID
Other
Enumeration date
04/08/2008
Last updated
04/08/2008
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