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Individual

MICHELLE TACKETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
R.D.H.

Contact information

Practice address
119 RIVER DR, PIKEVILLE, KY 41501-1685
(606) 437-5500
(606) 437-0873
Mailing address
119 RIVER DR, PIKEVILLE, KY 41501-1685
(606) 437-5500
(606) 437-0873

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
3701
KY

Other

Enumeration date
11/17/2014
Last updated
11/17/2014
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