IndividualActive
Dennis Michaelson, DMD MS
NPI 1609958479 · Orthodontics and Dentofacial Orthopedics Dentistry · Burley, ID
Provider details
- NPI number
- 1609958479
- Entity type
- Individual
- Primary specialty
- Orthodontics and Dentofacial Orthopedics DentistryDental Providers
- Credential
- DMD MS
- Sex
- Male
- Sole proprietor
- No
- License
- D1497OR (ID)
Specialties & taxonomies
Dental Providers
Practice location
2271 Overland Ave
Suite 4
Burley, ID 83318
Phone: (208) 678-3265
Fax: (208) 678-5206
Approximate (ZIP-level) locationGet directions
Mailing address
2271 Overland Ave
Burley, ID 83318
Registry dates
- Enumerated
- 2006-10-20
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.