Individual
EMMA L MUPOTSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
6270 W MAIN ST, INTERCARE COMMUNITY HEALTH NETWORK, EAU CLAIRE, MI 49111-9480
(269) 461-6927
(269) 461-3068
Mailing address
50 INDUSTRIAL PARK ROAD, BANGOR, MI 49013
(269) 427-7937
(269) 427-5180
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2902017595
MI
Other
Enumeration date
03/28/2016
Last updated
03/28/2016
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