Individual
MICHELE VAUGHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2167 FIX RD, GRAND ISLAND, NY 14072-2547
(716) 583-2922
Mailing address
2167 FIX RD, GRAND ISLAND, NY 14072-2547
(716) 583-2922
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
057190
NY
Other
Enumeration date
06/22/2011
Last updated
01/04/2016
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