Mary Margaret Tikkanen
Individual provider Active NPI Dental Assistant · Baraga, MI
NPI 1114010063 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1114010063
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dental Assistant 126800000X
- Practice address
- 102 Superior Ave
Baraga, MI 49908-9673 - Phone
- (906) 353-8787
- Fax
- (906) 353-8799
- NPI assigned
- Oct 2, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Assistant | 126800000X | Yes |
Addresses
Primary practice location
102 Superior Ave
Baraga, MI 49908-9673
Mailing address
102 Superior Ave
Baraga, MI 49908-9673
Phone (906) 353-8787
Other providers in Baraga, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.