Individual
MRS. KRISTY KAY PRENTICE KERL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
121 JONATHON DR, JANESVILLE, WI 53548
(608) 756-2631
Mailing address
121 JONATHON DR, JANESVILLE, WI 53548
(608) 756-2631
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
3896016
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33804900
WISCONSIN MEDICAID AND BADGERCARE PROGRAMS
WI
Enumeration date
05/07/2008
Last updated
05/07/2008
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