Healthcare Provider Details

I. General information

NPI: 1215256607
Provider Name (Legal Business Name): KATHRYN MARIE MEISTER D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2010
Last Update Date: 03/06/2026
Certification Date: 03/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1308 12TH AVE
GRAFTON WI
53024-1926
US

IV. Provider business mailing address

1308 12TH AVE
GRAFTON WI
53024-1926
US

V. Phone/Fax

Practice location:
  • Phone: 262-377-0780
  • Fax:
Mailing address:
  • Phone: 262-377-0780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number6571-15
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: