Provider Demographics
NPI:1699451609
Name:PICKARD, MICHELE (RDH)
Entity type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:
Last Name:PICKARD
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 SKYLINE DR
Mailing Address - Street 2:
Mailing Address - City:BEAVER FALLS
Mailing Address - State:PA
Mailing Address - Zip Code:15010-1235
Mailing Address - Country:US
Mailing Address - Phone:724-561-6479
Mailing Address - Fax:
Practice Address - Street 1:2807 WILMINGTON RD
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16105-1263
Practice Address - Country:US
Practice Address - Phone:724-656-3486
Practice Address - Fax:724-598-7337
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADH070262124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist