Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 2901601049 | MI |
NPI | 1003488693 |
---|---|
Provider Name | Mckinlee Michelle Taylor |
First Address | Ann Arbor, MI 48105-9271 |
Second Address | Ann Arbor, MI 48104-1511 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2021 |
Last Update Date | 13/07/2021 |