Individual
DR. KATHLEEN MARIE ELLSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
60 N. BRIDGE ST, SARANAC, MI 48881
(616) 642-3500
Mailing address
60 N. BRIDGE ST, PO BOX 70, SARANAC, MI 48881
(616) 642-3500
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901016334
MI
Other
Enumeration date
05/27/2005
Last updated
04/07/2022
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