Individual
TIFFANY KIMMEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6085 9 MILE RD NE, ROCKFORD, MI 49341-7747
(570) 847-7815
Mailing address
6085 9 MILE RD NE, ROCKFORD, MI 49341-7747
(570) 847-7815
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901600545
MI
Other
Enumeration date
07/23/2020
Last updated
07/23/2020
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