Individual
PAUL RUDOLPH MICHAELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
121 E FRONT AVE, BISMARCK, ND 58504-5589
(701) 223-1194
Mailing address
121 E FRONT AVE, BISMARCK, ND 58504-5589
(701) 223-1194
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2484
ND
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/08/2023
Last updated
07/06/2023
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