Individual
ALEXIS GEORGOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
508 W LAKE ST, TAWAS CITY, MI 48763-8318
(989) 362-6159
Mailing address
3950 DUPRIE RD, STANDISH, MI 48658-9403
(989) 313-1674
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901600502
MI
Other
Enumeration date
07/28/2020
Last updated
07/28/2020
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