Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 2902016288 | MI |
NPI | 1083044812 |
---|---|
Provider Name | Mrs. Deena Lucille Noggle |
First Address | Dowagiac, MI 49047-1762 |
Second Address | Dowagiac, MI 49047-1762 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2013 |
Last Update Date | 14/11/2013 |