Jerelyn Mary Koosmann RDH

NPI 1023457918 - Dental Hygienist - 124Q00000X

NPI Details
NPI 1023457918
Gender Female
Enumeration Date 06/24/2013
Last Updated 06/24/2013
Entity Type Individual
Active Over 3 years ago
Practice Location
53585 NOKOMIS RD
ASHLAND WI, 54806-4272, US
Phone (715) 685-7887
Fax (715) 685-7857
Business Location
53585 NOKOMIS RD
ASHLAND WI, 54806-4272, US
Phone (715) 685-7887
Fax (715) 685-7857
Toxanomy
Taxonomy Code 124Q00000X
License State Wisconsin
License Number 5103-16
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According to our database, Mrs. Jerelyn Mary Koosmann RDH NPI is 1023457918, taxonomy code is 124Q00000X and license number is 5103-16, license state is located at Wisconsin. Jerelyn Mary Koosmann RDH physically located at 53585 Nokomis Rd, Ashland WI, 54806-4272. NPI Number Jerelyn Mary Koosmann RDH has the Individual type.

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1023457918 NPI number is provided on an as is basis without warranty of any kind. 1023457918 is maintained by the National Plan & Provider Enumeration System. The contents of Jerelyn Mary Koosmann RDH are for informational purposes only.