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NPI Code Detail

MEDICARE: MICHELE STRAETZ HYGIENIST

MEDICARE: MICHELE STRAETZ HYGIENIST
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1124Q00000XDental Hygienist5935WI

General Provider Information

NPI Number : 1790781185
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELE STRAETZ HYGIENIST
Provider Business Mailing Address
First Line : 2306 S KINNICKINNIC AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53207-1626
Country : US
Telephone Number : 414-744-8575
Fax Number : 414-744-8520
Provider Business Practice Location Address
First Line : 2306 S KINNICKINNIC AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53207-1626
Country : US
Telephone Number : 414-744-8575
Fax Number : 414-744-8520
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2005
Last Update Date : 07/08/2007

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Directions to “ MICHELE STRAETZ HYGIENIST” Practice Location

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