Individual
MADISON RAE MICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1951 OAK ST, NILES, MI 49120-3738
(269) 262-4749
(269) 262-4739
Mailing address
1951 OAK ST, NILES, MI 49120-3738
(269) 262-4749
(269) 262-4739
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901600158
MI
Other
Enumeration date
06/27/2019
Last updated
08/21/2025
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