MEDICARE: MRS. KARA MICHELLE GEE RDH, BS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	124Q00000X	Dental Hygienist	2902015675	MI

General Provider Information

NPI Number	:	1699147843
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KARA MICHELLE GEE RDH, BS

Provider Business Mailing Address
First Line	:	1060 FAIRHOME RD
Second Line	:
City	:	GROSSE POINTE WOODS
State	:	MI
Zip	:	48236
Country	:	US
Telephone Number	:	586-883-0885
Fax Number	:

Provider Business Practice Location Address
First Line	:	6900 EAST 10 MILE RD.
Second Line	:
City	:	CENTERLINE
State	:	MI
Zip	:	48015
Country	:	US
Telephone Number	:	586-467-0980
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/28/2015
Last Update Date	:	10/28/2015

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