Jill A Susalla

NPI #1235638586 in Mount Morris, Michigan

Provider Information

NPI Number: 1235638586
Entity Type: Individual
Name: Jill A Susalla
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dental Hygienist
Enumeration Date: Feb 1, 2018
Last Updated: Feb 1, 2018

Practice Location

Address: 8326 N SAGINAW RD
City: Mount Morris
State: Michigan
ZIP Code: 48458-1648
Phone: (810) 687-5040

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dental Hygienist	124Q00000X	Primary

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