| Dennis Michaelson D.m.d., Ms | |
|
2271 Overland Ave Ste 4 Burley ID 83318-2957 | |
| (208) 678-3265 | |
| (208) 678-5206 |
| Full Name | Dennis Michaelson D.m.d., Ms |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 2271 Overland Ave Ste 4, Burley, Idaho |
| Authorized Official Name and Position | Dennis J Michaelson (OWNER) |
| Authorized Official Contact | 2086783265 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dennis Michaelson D.m.d., Ms 2271 Overland Ave Ste 4 Burley ID 83318-2957 Ph: (208) 678-3265 | Dennis Michaelson D.m.d., Ms 2271 Overland Ave Ste 4 Burley ID 83318-2957 Ph: (208) 678-3265 |
| NPI Number | 1265605596 |
|---|---|
| Provider Enumeration Date | 04/08/2008 |
| Last Update Date | 04/08/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265605596 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 67D1497 (Idaho) | Primary |
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