Individual
DR. CYNTHIA MAE WIGGINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1550 COMMERCE DR, ALPHA OMEGA DENTAL CENTER, MARQUETTE, MI 49855-8640
(906) 225-1100
Mailing address
1550 COMMERCE DR., ALPHA OMEGA DENTAL CENTER, MARQUETTE, MI 49855
(906) 225-1100
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
016962
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016962
STATE LICENSE ID NO.
MI
Enumeration date
04/17/2007
Last updated
07/08/2007
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