Kyra Mickelson, RDH

NPI #1699430041 in Fort Wainwright, Alaska

Provider Information

NPI Number: 1699430041
Entity Type: Individual
Name: Kyra Mickelson, RDH
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dental Hygienist
Credential: RDH
Enumeration Date: Nov 1, 2021
Last Updated: Nov 1, 2021

Practice Location

Address: 4192 6TH ST APT 4
City: Fort Wainwright
State: Alaska
ZIP Code: 99703-1260
Phone: (928) 679-5898

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dental Hygienist	124Q00000X	Primary

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