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Individual

MISS IRICE ELLIS-CRENSHAW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RDH

Contact information

Practice address
17344 W 12 MILE RD STE 201, SOUTHFIELD, MI 48076-6321
(586) 277-8491
Mailing address
17344 W 12 MILE RD STE 201, SOUTHFIELD, MI 48076-6321
(586) 277-8491

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2902019162
MI

Other

Enumeration date
08/12/2021
Last updated
08/12/2021
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