Individual
JENNA LYNN MELLEROWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4189 HIGHLAND RD, WATERFORD, MI 48328-2136
(248) 618-2029
Mailing address
4189 HIGHLAND RD, WATERFORD, MI 48328-2136
(248) 618-2029
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901023218
MI
Other
Enumeration date
06/18/2019
Last updated
06/18/2019
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