Individual
KACIE KAY WOODIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
370 3RD AVE S, ISLE, MN 56342-4573
(320) 676-3232
Mailing address
10494 PIERCE ST NE, BLAINE, MN 55434-3682
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D13123
MN
Other
Enumeration date
06/25/2012
Last updated
06/25/2012
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