Healthcare Provider Details
I. General information
NPI: 1295699692
Provider Name (Legal Business Name): KP DENTISTRY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1284 W GRAND RIVER AVE
WILLIAMSTON MI
48895-9374
US
IV. Provider business mailing address
1284 W GRAND RIVER AVE
WILLIAMSTON MI
48895-9374
US
V. Phone/Fax
- Phone: 517-655-2993
- Fax: 517-655-1380
- Phone: 517-655-2993
- Fax: 517-655-1380
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
KRISTINA
PALMER
Title or Position: OWNER
Credential: DDS
Phone: 517-420-4037