Individual
KATHRYN LEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
800 1ST AVE SW, AUSTIN, MN 55912-2507
(507) 437-8208
Mailing address
800 1ST AVE SW, AUSTIN, MN 55912-2507
(507) 437-8208
Taxonomy
Speciality
Code
Description
License number
State
125J00000X
Dental Therapist
Primary
DT127
MN
Other
Enumeration date
07/29/2020
Last updated
07/29/2020
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