Individual provider · Type 1 NPI

Mackenzie Wickman

Dental Hygienist · Lakewood, WI

NPI number 1104297571 Active

Practice location

15397 State Highway 32
Lakewood, WI 54138-9702

Call (715) 276-6321 Map

Fax (715) 276-1428

Mailing address

PO Box 179
Lakewood, WI 54138-0179

Specialties and licenses

TaxonomyCodeLicense
Dental Hygienist Primary 124Q00000X1002641 (WI)

Dental Hygienist: An individual who has completed an accredited dental hygiene education program, and an individual who has been licensed by a state board of dental examiners to provide preventive care services under the supervision of a dentist. Functions that may be legally delegated to the dental hygienist vary based on the needs of the dentist, the educational preparation of the dental hygienist and state dental practice acts and…

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About NPI 1104297571

Mackenzie Wickman's National Provider Identifier is 1104297571, issued on Oct 12, 2015. The primary taxonomy on file is Dental Hygienist (124Q00000X), and the practice location is in Lakewood, WI. The record was last updated on Oct 31, 2024.