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General NPI Number Information
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NPI Number | 1417097411
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Entity Type | Individual
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Provider Name | KIMBERLY KAY STURM DDS
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Gender | Female
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 07/19/2016
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Provider Practice Location Address
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Address Line | 53585 NOKOMIS RD
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City | ASHLAND
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State | WI
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Zip | 54806-4272
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Country | US
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Telephone | 715-685-7887
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Fax | 715-685-7886
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Provider Business Mailing Address
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Address Line | 53585 NOKOMIS RD
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City | ASHLAND
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State | WI
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Zip | 54806-4272
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Country | US
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Telephone | 715-685-7887
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Fax | 715-685-7886
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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 | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number | 10021
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 6668-15
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License Number State | WI
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