Individual
MS. KELLY SUE KLUG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.H.
Contact information
Practice address
1017 W GLEN OAKS LN, SUITE 211, MEQUON, WI 53092-3371
(262) 241-4440
(262) 241-3331
Mailing address
1017 W GLEN OAKS LN, SUITE 211, MEQUON, WI 53092-3371
(262) 241-4440
(262) 241-3331
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
5801-016
WI
Other
Enumeration date
01/30/2007
Last updated
07/08/2007
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