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Individual
DR. AUDREY MICHELLE MIKKELSON
Active
Individual
DR. AUDREY MICHELLE MIKKELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD, MSD
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D10484
OR
1223P0221X
Pediatric Dentistry
DE61168847
WA
Other
Enumeration date
04/22/2015
Last updated
11/05/2024
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