Individual
PETER A MICHAELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
150 HAZARD AVE, ENFIELD, CT 06082-4575
(860) 749-0212
(860) 749-2189
Mailing address
150 HAZARD AVE, ENFIELD, CT 06082-4575
(860) 749-0212
(860) 749-2189
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6047
CT
Other
Enumeration date
04/03/2007
Last updated
02/22/2016
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