Individual
DR. MICHELLE ENJILIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
1504 DENTAL DR, BEDFORD, IN 47421-3574
(812) 275-7112
Mailing address
4236 E CAMBRIDGE DR, BLOOMINGTON, IN 47408-3107
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12011760A
IN
Other
Enumeration date
01/24/2012
Last updated
01/24/2012
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