Healthcare Provider Details

I. General information

NPI: 1609101377
Provider Name (Legal Business Name): ROBBYN L KUESTER RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2009
Last Update Date: 10/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

N2584 RICHLAND RD
MONROE WI
53566-9555
US

IV. Provider business mailing address

N2584 RICHLAND RD
MONROE WI
53566-9555
US

V. Phone/Fax

Practice location:
  • Phone: 608-329-7518
  • Fax:
Mailing address:
  • Phone: 608-329-7518
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number5567-16
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: