Mikkelson, Audrey Michelle

Mikkelson, Audrey Michelle is an individual health care provider with primary practice located at 3745 Portland Rd Ne Ste 190 , Salem OR 97301-0529. She recently has 2 registered licenses in different health care specialties including Dental Providers / Pediatric Dentistry, Dental Providers / General Practice. Dental Providers / General Practice is her primary health care specialty. Mikkelson, Audrey Michelle can be contacted via phone (971) 232-5858.

Contact Information

Primary practice address
3745 Portland Rd Ne Ste 190 Salem OR 97301-0529
Phone: (971) 232-5858
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X D10484 Oregon
Dental Providers / General Practice 1223G0001X D10484 Oregon
Dental Providers / Pediatric Dentistry 1223P0221X DE61168847 Washington

Profile Details

NPI number 1912394578
LBN Legal business name Mikkelson, Audrey Michelle
Credentials DMD, MSD
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 22nd, 2015
Last updated Sep 29th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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