Individual
MRS. ELISA DACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
630 PROGRESS ST, WEST BRANCH, MI 48661-8603
(989) 345-5020
Mailing address
PO BOX 806, WEST BRANCH, MI 48661-0806
(989) 965-1652
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2902012908
MI
Other
Enumeration date
12/27/2022
Last updated
12/27/2022
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