Individual
CARRIE KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
G5399 N SAGINAW ST, FLINT, MI 48505-1536
(810) 785-0863
(810) 785-0865
Mailing address
225 E 5TH ST, SUITE 300, FLINT, MI 48502-1641
(810) 406-4912
(810) 424-6029
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2902008619
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0B56065
MEDICARE GROUP PTAN
MI
01
—
1386624278
GROUP NPI
MI
Enumeration date
12/27/2010
Last updated
12/28/2010
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