Individual
MICHELLE MULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.H.
Contact information
Practice address
W286N991 SHEPHERDS WAY, WAUKESHA, WI 53188-9493
(262) 617-0178
Mailing address
W286 N991 SHEPHERDS WAY, SMILES 4 LIFE, INC, WAUKESHA, WI 53188
(262) 617-0178
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
6503-16
WI
Other
Enumeration date
07/28/2014
Last updated
07/28/2014
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