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General NPI Number Information
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NPI Number | 1285162073
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Entity Type | Individual
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Provider Name | ANGIE LYN BENDER R.D.H.
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Gender | Female
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Dates
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Enumeration Date | 05/24/2017
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Last Update Date | 07/31/2023
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Provider Practice Location Address
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Address Line | 5095 RIFLE RIVER TRAIL
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City | ALGER
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State | MI
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Zip | 48610-9327
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Country | US
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Telephone | 989-873-5152
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Fax | 989-873-5913
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Provider Business Mailing Address
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Address Line | 5095 RIFLE RIVER TRAIL
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City | ALGER
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State | MI
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Zip | 48610-9327
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Country | US
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Telephone | 989-873-5152
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Fax | 989-873-5913
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 2902018130
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License Number State | MI
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