Individual
MARISA MATTHEWS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5780 EAGLE RD, WHITE LAKE, MI 48383-1210
(248) 961-0438
Mailing address
5780 EAGLE RD, WHITE LAKE, MI 48383-1210
(248) 961-0438
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2902017954
MI
Other
Enumeration date
08/15/2016
Last updated
08/15/2016
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