MEDICARE: KRISTEN MILLER-LAUZON DDS

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	1223G0001X	General Practice Dentistry	2901600473	MI

General Provider Information

NPI Number	:	1730791153
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN MILLER-LAUZON DDS

Provider Business Mailing Address
First Line	:	17711 FORT ST
Second Line	:
City	:	RIVERVIEW
State	:	MI
Zip	:	48193-6632
Country	:	US
Telephone Number	:	734-283-2818
Fax Number	:

Provider Business Practice Location Address
First Line	:	17711 FORT ST
Second Line	:
City	:	RIVERVIEW
State	:	MI
Zip	:	48193-6632
Country	:	US
Telephone Number	:	734-283-2818
Fax Number	:

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

Provider Enumeration Date	:	08/18/2020
Last Update Date	:	11/17/2021

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Directions to “ KRISTEN MILLER-LAUZON DDS” Practice Location

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