Individual
MRS. JENNIFER CATHERINE MICKLE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
4700 LAS VEGAS BLVD N, SUITE 2419, LAS VEGAS, NV 89191-6600
(702) 653-2654
Mailing address
3193 WILLOW RUN DR, MERCED, CA 95340-8315
(702) 653-2654
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
20007928
IL
Other
Enumeration date
01/04/2006
Last updated
07/08/2007
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