NPI 1760783807

Debra Lee Mickelson, RDH

Practitioner Dental Hygienist Menasha, WI

Practice location

Address: 1814 Appleton Rd, Menasha, WI 54952-1110
Phone: (920) 731-7445
Fax: (920) 731-7490

Registered specialties

Dental Hygienist Primary

Dental Providers Taxonomy 124Q00000X Licence 10011956 (WI)

Other Dental Hygienist providers in Wisconsin →

Registry record

NPI: 1760783807
Entity type: Individual
Sex (as registered): Female
NPI issued: 5 Nov 2010
Record last updated: 5 Nov 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.