Individual
SERRA LIPA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1547 KENNETH ST, OWOSSO, MI 48867-1346
(989) 780-4212
Mailing address
1547 KENNETH ST, OWOSSO, MI 48867-1346
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2902017837
MI
Other
Enumeration date
10/03/2016
Last updated
10/03/2016
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