Individual
MRS. MICHONNE DANIELLE WEST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
310 W ELM ST, ATHENS, AL 35611-4802
(256) 272-9147
Mailing address
161 KELLY CREEK RD, ARDMORE, TN 38449-3004
(256) 508-5539
(256) 508-5539
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
34715
TX
1223G0001X
General Practice Dentistry
Primary
D-0007011-C1
AL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/06/2018
Last updated
10/28/2022
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