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1134208978
MICHAEL TISDELLE
CHARLOTTESVILLE, VA
NPI
1134208978
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: VA 0401007112)
Enumeration Date
2006-11-03
Last Update Date
2007-07-08
Business Address
Dr. MICHAEL TISDELLE DDS
2216 IVY RD STE 205
CHARLOTTESVILLE, VA 22903-4966
Phone number: 434-977-4101
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Mailing Address
Dr. MICHAEL TISDELLE DDS
2216 IVY RD STE 205
CHARLOTTESVILLE, VA 22903-4966
Phone number: 434-977-4101
Copy
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