Nicole Shively

NPI #1407319767 in Benzonia, Michigan

Provider Information

NPI Number: 1407319767
Entity Type: Individual
Name: Nicole Shively
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dental Hygienist
Enumeration Date: Apr 12, 2019
Last Updated: Apr 12, 2019

Practice Location

Address: 6051 FRANKFORT HWY
City: Benzonia
State: Michigan
ZIP Code: 49616-9558
Phone: (231) 383-4800

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dental Hygienist	124Q00000X	Primary

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