Individual
DR. KENNETH FREDERICK TISEO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
204 W SHERMAN ST, CARO, MI 48723-1534
(989) 673-2939
Mailing address
171 GOLFVIEW DR, CARO, MI 48723-1212
(989) 673-1593
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901014518
MI
Other
Enumeration date
05/21/2006
Last updated
07/08/2007
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