Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 292011361 | MI |
NPI | 1043683998 |
---|---|
Provider Name | Holly A Schaeffer |
First Address | Midland, MI 48642-3250 |
Second Address | Midland, MI 48642-3250 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2015 |
Last Update Date | 31/10/2015 |