Individual
KRISTINA B WELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
12 S 4TH ST, LANSE, MI 49946
(906) 524-6420
Mailing address
12 S 4TH ST, LANSE, MI 49946-1404
(906) 524-6420
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
1001442 - 15
WI
122300000X
Dentist
Primary
2901022135
MI
122300000X
Dentist
D14328
MN
Other
Enumeration date
06/15/2016
Last updated
04/13/2020
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