Elison, Michael Aaron
Elison, Michael Aaron is an individual health care provider with primary practice located at 3656 Washington Parkway , Idaho Falls ID 83404. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Elison, Michael Aaron can be contacted via phone (208) 522-7216.Contact Information
Primary practice address
3656 Washington Parkway
Idaho Falls ID 83404
Phone: (208) 522-7216
Fax: (208) 524-3851
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | D3605 | Idaho |
Profile Details
| NPI number | 1205864832 |
|---|---|
| LBN Legal business name | Elison, Michael Aaron |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 30th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1205864832 | NPPES |
| Idaho | MEDICAID | 80638000 |
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