Individual
MARIAH M MAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
105 E BLUFF ST, BOSCOBEL, WI 53805-1610
(608) 654-5100
(608) 654-7408
Mailing address
PO BOX 39, CASHTON, WI 54619-0039
(608) 654-5100
(608) 654-7408
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
1003723
WI
Other
Enumeration date
11/23/2020
Last updated
11/23/2020
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