Healthcare Provider Details

I. General information

NPI: 1447789193
Provider Name (Legal Business Name): CHELSEA LYNN KLIPFEL DDS, PLLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. CHELSEA LYNN RICK

II. Dates (important events)

Enumeration Date: 06/07/2017
Last Update Date: 07/21/2022
Certification Date: 01/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 E BEECH ST
FRUITPORT MI
49415-9210
US

IV. Provider business mailing address

40 E BEECH ST
FRUITPORT MI
49415-9210
US

V. Phone/Fax

Practice location:
  • Phone: 231-865-6141
  • Fax: 231-865-6198
Mailing address:
  • Phone: 231-865-6141
  • Fax: 231-865-6198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2901022307
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: