Individual
MS. KRISTIN MARIE VAUGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
595 N BROADWAY ST, COAL CITY, IL 60416-1046
(815) 634-8009
(815) 634-2008
Mailing address
1030 WILDY RD, MINOOKA, IL 60447-9795
(815) 830-0928
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019032292
IL
1223G0001X
General Practice Dentistry
019032292
IL
Other
Enumeration date
08/20/2019
Last updated
08/20/2019
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