Individual
ERIN DAWN KALLSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
125 SIEGLER ST, GREEN BAY, WI 54303-2635
(920) 592-8940
Mailing address
125 SIEGLER ST, GREEN BAY, WI 54303-2635
(920) 592-8940
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
6001153-15
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/05/2023
Last updated
08/31/2023
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