Individual
DR. MICHELLE CAROLYN WIECZYNSKI HUMBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS, BS
Contact information
Practice address
4348 ELECTRIC RD, ROANOKE, VA 24018-0720
(540) 769-0976
Mailing address
213 S JEFFERSON ST STE 1006, ROANOKE, VA 24011-1713
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401416151
VA
1223G0001X
General Practice Dentistry
0401416151
VA
Other
Enumeration date
05/14/2018
Last updated
02/24/2024
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