Individual
DR. PETER LOUIS MICHELICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4000 ANNAPOLIS LN N, SUITE 103, PLYMOUTH, MN 55447-5480
(763) 551-0501
(612) 573-6687
Mailing address
4000 ANNAPOLIS LN N, SUITE 103, PLYMOUTH, MN 55447-5480
(763) 551-0501
(612) 573-6687
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D7115
MN
Other
Enumeration date
10/19/2006
Last updated
07/08/2007
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