Individual
MICKI STAFKO-DOUGLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
745 RUSSELL ST, CRAIG, CO 81625-2019
(970) 824-8233
Mailing address
745 RUSSELL ST, CRAIG, CO 81625-2019
(970) 824-8233
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH.002023726
CO
Other
Enumeration date
04/05/2016
Last updated
04/05/2016
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