Provider Demographics
NPI:1407021991
Name:TINKER, MILDRED JEAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:MILDRED
Middle Name:JEAN
Last Name:TINKER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:G-4256 S. LINDEN RD.
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-2908
Mailing Address - Country:US
Mailing Address - Phone:810-732-9440
Mailing Address - Fax:810-732-5745
Practice Address - Street 1:G-4256 S. LINDEN RD.
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-2908
Practice Address - Country:US
Practice Address - Phone:810-732-9440
Practice Address - Fax:810-732-5745
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-25
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010135221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice