Organization
FRANK MIKKELSEN DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FRANK MIKKELSEN DDS (OWNER/DENTIST)
(209) 532-4607
Entity
Organization
Contact information
Practice address
19060 STANDARD RD STE 4, SONORA, CA 95370-7560
(209) 532-4607
(209) 533-5487
Mailing address
19060 STANDARD RD STE 4, SONORA, CA 95370-7560
(209) 532-4607
(209) 533-5487
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
30435
CA
Other
Enumeration date
06/15/2016
Last updated
06/15/2016
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