IndividualActive
Nicole Wax
NPI 1285974097 · Oral and Maxillofacial Pathology Dentistry · Linden, MI
Provider details
- NPI number
- 1285974097
- Entity type
- Individual
- Primary specialty
- Oral and Maxillofacial Pathology DentistryDental Providers
- Sex
- Female
- Sole proprietor
- Yes
- License
- 2901021150 (MI)
Specialties & taxonomies
Dental Providers
Practice location
120 N Bridge St Ste C
Linden, MI 48451-8823
Phone: (810) 458-6188
Approximate (ZIP-level) locationGet directions
Mailing address
16215 Grand View Rd
Fenton, MI 48430-9194
Registry dates
- Enumerated
- 2013-02-15
- Last updated
- 2025-07-01
- Certified
- 2025-07-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.