Individual
KAYLEE MICHELE DERUSHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
14150 HAMILTON LAKE RD, NEWBERRY, MI 49868
(906) 293-5107
Mailing address
14150 HAMILTON LAKE RD, NEWBERRY, MI 49868
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2902019413
MI
Other
Enumeration date
06/22/2023
Last updated
06/22/2023
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