Individual
COLLEEN ANN ISRAELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
8063 HADLEY AVE S, UPPER LEVEL, COTTAGE GROVE, MN 55016-2652
(651) 459-4894
(651) 458-4940
Mailing address
9314 9TH ST N, LAKE ELMO, MN 55042-9739
(651) 738-9630
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D10501
MN
Other
Enumeration date
12/01/2006
Last updated
03/24/2008
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