Individual
SALLY SIMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1111 LANGLADE RD, ANTIGO, WI 54409-2787
(715) 627-4383
Mailing address
2580 ENTERPRISE DR, SHEBOYGAN, WI 53083-2602
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
—
—
Other
Enumeration date
11/07/2022
Last updated
11/07/2022
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