Individual
DR. TRACEY JEAN DELLAVECCHIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
430 130TH AVE, DOUGLAS, MI 49406-5100
(269) 857-1431
(269) 857-4089
Mailing address
PO BOX 109, DOUGLAS, MI 49406-0109
(269) 857-1431
(269) 857-4089
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901018649
MI
Other
Enumeration date
02/27/2006
Last updated
08/06/2009
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