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Organization
T.L.MIKESELL DDS, PC
Active
Organization
T.L.MIKESELL DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOR LYN MIKESELL DDS (PRESIDENT)
(231) 271-3315
Entity
Organization
Contact information
Practice address
408 ST JOSEPH AVE, SUTTONS BAY, MI 49682-0759
(231) 271-3315
(231) 271-3317
Mailing address
PO BOX 759, SUTTONS BAY, MI 49682-0759
(231) 271-3315
(231) 271-3317
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/12/2022
Last updated
08/12/2022
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