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Dental Providers Dental Hygienist

Provider NPI: 1851640478

Provider Information:
Gender: F
Not Sole Proprietor

Practice Location:
1420 LONDON RD SUITE 206 DULUTH, MN 55805-2433 US
Tel: 218-481-7474  Fax: 218-789-4150

Business Mailing Address:
1420 LONDON RD SUITE 206 DULUTH, MN 55805-2433 US
Tel: 218-481-7474  Fax: 218-789-4150

NPI Information:
NPI: 1851640478
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Y124Q00000XDental Providers
Dental Hygienist
N124Q00000XDental Providers
Dental Hygienist

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 124Q00000X





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