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DIANE MAGNUS RDH
>> Dental Hygienist >> Dental ProvidersRegistrant NPI Number: 1013409713
Individual Registrant: DIANE MAGNUS RDH
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
380 N STATE RD OTISVILLE, MI 48463-9486 US
Tel: 810-631-4524 Fax: 810-631-7041
Tel: 810-631-4524 Fax: 810-631-7041
Contact information for business:
380 N STATE RD OTISVILLE, MI 48463-9486 US
Tel: 810-631-4524 Fax: 810-631-7041
Tel: 810-631-4524 Fax: 810-631-7041
Registration Information:
NPI: 1013409713
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 124Q00000X | Dental Providers Dental Hygienist | MI |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
