Individual
MS. MELISSA ELLEN KJOS-PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH, LAP,CIHC
Contact information
Practice address
206 GARLAND ST, KALISPELL, MT 59901-2509
(406) 253-3770
Mailing address
PO BOX 8946, KALISPELL, MT 59904-1946
(406) 253-3770
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
710
MT
Other
Enumeration date
02/01/2020
Last updated
02/01/2020
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