Individual
KELSEY CHIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
888 THACKERAY TRL STE 215, OCONOMOWOC, WI 53066-4342
(262) 567-6003
Mailing address
888 THACKERAY TRL STE 215, OCONOMOWOC, WI 53066-4342
(262) 567-6003
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019.032759
IL
122300000X
Dentist
Primary
1002420-15
WI
Other
Enumeration date
07/13/2020
Last updated
10/04/2020
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