Individual
AMANDA THAXTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1525 E CHICAGO RD, STURGIS, MI 49091-1991
(269) 651-7760
Mailing address
1525 E CHICAGO RD, STURGIS, MI 49091-1991
(269) 651-7760
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2902017522
MI
Other
Enumeration date
12/15/2016
Last updated
12/15/2016
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