Individual
DR. MICHAEL CHRISTOPHER CHISICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1631 WETZEL AVE, BLDG 815, FORT CARSON, CO 80913-4095
(719) 526-5537
(719) 524-2843
Mailing address
1631 WETZEL AVE, BLDG 815, FORT CARSON, CO 80913-4095
(719) 526-5537
(719) 524-2843
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
30-022838
OH
122300000X
Dentist
59659
CA
122300000X
Dentist
DE60198298
WA
122300000X
Dentist
Primary
DEN.00106346
CO
122300000X
Dentist
RES.2658
OH
Other
Enumeration date
12/23/2009
Last updated
05/27/2016
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