Individual
MISS ALISA PUVALOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
58144 GRATIOT AVE, NEW HAVEN, MI 48048
(586) 749-8002
(586) 749-5381
Mailing address
PO BOX 480430, NEW HAVEN, MI 48048-0430
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
—
—
Other
Enumeration date
05/21/2018
Last updated
05/21/2018
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