MEDICARE: DR. KIMBERLY KAY STURM DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223D0001X	Public Health Dentistry	10021	MN
2	261Q00000X	Clinic/Center	6668-15	WI

General Provider Information

NPI Number	:	1417097411
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIMBERLY KAY STURM DDS

Provider Business Mailing Address
First Line	:	53585 NOKOMIS RD
Second Line	:
City	:	ASHLAND
State	:	WI
Zip	:	54806-4272
Country	:	US
Telephone Number	:	715-685-7887
Fax Number	:	715-685-7886

Provider Business Practice Location Address
First Line	:	53585 NOKOMIS RD
Second Line	:
City	:	ASHLAND
State	:	WI
Zip	:	54806-4272
Country	:	US
Telephone Number	:	715-685-7887
Fax Number	:	715-685-7886

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/07/2007
Last Update Date	:	07/19/2016

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