Individual
MS. VICKI SAN SOUCI
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
323 W ALDER ST, MISSOULA, MT 59802-4123
(406) 258-4191
(406) 258-4180
Mailing address
323 W ALDER ST, MISSOULA, MT 59802-4123
(406) 258-4191
(406) 258-4180
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
793
MT
Other
Enumeration date
06/04/2006
Last updated
07/08/2007
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