Individual
ANGELA KMIECIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1495 FORT ST, WYANDOTTE, MI 48192-3036
(734) 330-1562
Mailing address
43700 N GRATIOT AVE, CLINTON TWP, MI 48036-3331
(586) 246-8464
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2902015043
MI
Other
Enumeration date
03/20/2013
Last updated
03/20/2013
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