MEDICARE: MICHELLE MUSSEHL RDH

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
1	124Q00000X	Dental Hygienist	4317-16	WI

General Provider Information

NPI Number	:	1982272498
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE MUSSEHL RDH

Provider Business Mailing Address
First Line	:	N8448 TUNNEL RD
Second Line	:
City	:	NEW GLARUS
State	:	WI
Zip	:	53574-9751
Country	:	US
Telephone Number	:	608-444-4022
Fax Number	:

Provider Business Practice Location Address
First Line	:	N8448 TUNNEL RD
Second Line	:
City	:	NEW GLARUS
State	:	WI
Zip	:	53574-9751
Country	:	US
Telephone Number	:	608-444-4022
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2021
Last Update Date	:	06/12/2021

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Directions to “ MICHELLE MUSSEHL RDH” Practice Location

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