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Individual
DR. MIKAELA KOFMAN
Active
Individual
DR. MIKAELA KOFMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
1741998
MI
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2901600522
MI
Other
Enumeration date
06/24/2019
Last updated
08/23/2021
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