Individual
KELLY KATHLEEN BEARSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.H.
Contact information
Practice address
6715 OLD 28TH ST SE, GRAND RAPIDS, MI 49546-6923
(616) 949-0730
Mailing address
639 EASTERN AVE NE, GRAND RAPIDS, MI 49503-1810
(616) 322-1236
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2902013595
MI
Other
Enumeration date
11/25/2014
Last updated
11/25/2014
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