Individual
MRS. CRYSTAL JUJUAN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.H.
Contact information
Practice address
43401 N JEFFERSON AVE BLDG 825, SELFRIDGE ANG BASE, SELFRIDGE ANGB, MI 48045-5266
(586) 239-3005
(586) 239-5010
Mailing address
43401 N JEFFERSON AVE BLDG 825, SELFRIDGE ANG BASE, SELFRIDGE ANGB, MI 48045-5266
(586) 239-3005
(586) 239-5010
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2902011199
MI
Other
Enumeration date
05/08/2012
Last updated
05/08/2012
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