Individual
KAITLIN SIEWERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
520 MAIN STREET, HAWLEY, MN 56549
(218) 483-1038
(218) 483-1339
Mailing address
PO BOX 849, HAWLEY, MN 56549
(218) 483-1038
(218) 483-1339
Taxonomy
Speciality
Code
Description
License number
State
125K00000X
Advanced Practice Dental Therapist
Primary
DT60
MN
Other
Enumeration date
10/08/2015
Last updated
10/10/2018
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