Individual
FAITH C PRISTEL-MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
141 W FRONT ST, PESHTIGO, WI 54157-1421
(715) 582-3601
Mailing address
141 W FRONT ST, PESHTIGO, WI 54157-1421
(715) 582-3601
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4464
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33736400
—
WI
Enumeration date
03/30/2007
Last updated
07/09/2007
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