| Mickelwait Family Dentistry Pllc | |
|
1420 Roosevelt Ave Ste 7 Mount Vernon WA 98273-2687 | |
| (360) 424-3450 | |
| (360) 428-0927 |
| Full Name | Mickelwait Family Dentistry Pllc |
|---|---|
| Speciality | Dentist |
| Location | 1420 Roosevelt Ave, Mount Vernon, Washington |
| Authorized Official Name and Position | Joel S Mickelwait (MEMBER) |
| Authorized Official Contact | 3604243450 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mickelwait Family Dentistry Pllc 1420 Roosevelt Ave Ste 7 Mount Vernon WA 98273-2687 Ph: (360) 424-3450 | Mickelwait Family Dentistry Pllc 1420 Roosevelt Ave Ste 7 Mount Vernon WA 98273-2687 Ph: (360) 424-3450 |
| NPI Number | 1568795649 |
|---|---|
| Provider Enumeration Date | 09/08/2009 |
| Last Update Date | 09/08/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568795649 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DE60070169 (Washington) | Primary |
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