Individual
IAN T KITTELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1113 PROGRESS DR, MEDFORD, OR 97504-5201
(541) 535-6239
(541) 512-1026
Mailing address
3617 S PACIFIC HWY, MEDFORD, OR 97501-8957
(541) 535-6239
(541) 535-4377
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D9492
OR
Other
Enumeration date
08/06/2010
Last updated
12/30/2016
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