Individual
TRISHA RENEE FAZEKAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
24040 DUGAN DR, NEW BOSTON, MI 48164-9722
(734) 652-8492
Mailing address
24040 DUGAN DR, NEW BOSTON, MI 48164-9722
(734) 652-8492
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2902018060
MI
Other
Enumeration date
11/29/2016
Last updated
11/29/2016
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