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General NPI Number Information
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NPI Number | 1306405584
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Entity Type | Individual
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Provider Name | KRISTINE MICHELE ZELMER RDH
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Gender | Female
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Dates
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Enumeration Date | 06/11/2019
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 58620 SINK RD
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City | DOWAGIAC
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State | MI
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Zip | 49047-9329
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Country | US
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Telephone | 269-783-2495
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Fax |
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Provider Business Mailing Address
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Address Line | 68680 CHRISTIANA LAKE RD
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City | EDWARDSBURG
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State | MI
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Zip | 49112-8727
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Country | US
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Telephone | 269-697-3718
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 2902012925
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License Number State | MI
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