Provider Demographics
NPI:1558705715
Name:PERLSON, MICHELE H (RDH)
Entity Type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:H
Last Name:PERLSON
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:MICHELE
Other - Middle Name:H
Other - Last Name:HITCHCOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH
Mailing Address - Street 1:877 S BOULDER RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-1345
Mailing Address - Country:US
Mailing Address - Phone:303-665-8228
Mailing Address - Fax:303-665-8994
Practice Address - Street 1:877 S BOULDER RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-1345
Practice Address - Country:US
Practice Address - Phone:303-665-8228
Practice Address - Fax:303-665-8994
Is Sole Proprietor?:No
Enumeration Date:2013-04-18
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODH002023480124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist