Individual
KRISTEN LEE TADEWALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
217 E GRANT ST, CALEDONIA, MN 55921-1212
(507) 450-4297
Mailing address
217 E GRANT ST, CALEDONIA, MN 55921-1212
(507) 450-4297
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
HO4380
MN
Other
Enumeration date
08/23/2007
Last updated
08/23/2007
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