Individual
KIMBERLY DEGEORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.H.
Contact information
Practice address
1801 W WISCONSIN AVE, MILWAUKEE, WI 53233-2186
(414) 288-6895
Mailing address
PO BOX 1881, MILWAUKEE, WI 53201-1881
(414) 745-3210
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
682316
WI
Other
Enumeration date
11/06/2013
Last updated
11/06/2013
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