Individual
DAIDRIE ANN PROMERSBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1405 ANNE ST NW, BEMIDJI, MN 56601-5113
(218) 444-9646
Mailing address
1405 ANNE ST NW, BEMIDJI, MN 56601-5113
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
—
—
172V00000X
Community Health Worker
—
—
Other
Enumeration date
07/18/2012
Last updated
01/18/2017
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