Individual
DR. KATHLEEN MARIE EISIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S, M.S.,PLLC
Contact information
Practice address
6677 CROSSINGS DRIVE SE, SUITE #3, GRAND RAPIDS, MI 49508
(616) 656-0100
(616) 656-0400
Mailing address
6677 CROSSINGS DR SE, GRAND RAPIDS, MI 49508-7889
(616) 656-0100
(616) 656-0400
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
2901018765
MI
Other
Enumeration date
01/30/2007
Last updated
07/08/2007
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