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Individual

KRISTA JEAN KOEHLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
6411 RICHFIELD PKWY, RICHFIELD, MN 55423-6400
(612) 869-3440
Mailing address
1016 WASHINGTON AVE SE APT 911, MINNEAPOLIS, MN 55414-4111
(715) 207-2692

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D14180
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
D14180
MN BOARD OF DENTISTRY
MN
Enumeration date
05/17/2019
Last updated
05/17/2019
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