Individual
ASHLEIGH LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
122 HIGHLAND DR, JACKSON, MI 49201-9164
(517) 740-7422
Mailing address
2527 CHATEAU DR, JACKSON, MI 49201-9719
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2902016316
MI
Other
Enumeration date
12/05/2016
Last updated
12/05/2016
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