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Individual

ELIZABETH ANN KAELSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
220 W GARFIELD AVE, CHARLEVOIX, MI 49720-1631
(231) 547-6523
(231) 547-6238
Mailing address
PO BOX 346, EMPIRE, MI 49630-0346

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901014853
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4140082
MI
Enumeration date
01/12/2007
Last updated
07/08/2007
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