Individual
DR. JESSICA ANN LICHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
1080 S VAN DYKE RD STE A, BAD AXE, MI 48413-9635
(989) 623-0137
(989) 921-4977
Mailing address
501 LAPEER AVE, SAGINAW, MI 48607-1203
(989) 759-6464
(989) 399-8233
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901021568
MI
Other
Enumeration date
05/19/2015
Last updated
04/09/2021
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