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Individual
MRS. SUSAN L SHORE-VIGNOLA
Active
Individual
MRS. SUSAN L SHORE-VIGNOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901014317
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4087824
—
MI
Enumeration date
08/30/2005
Last updated
05/03/2016
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