Individual
MS. KELLI GUMM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
326 CHAPIN ST, SOUTH BEND, IN 46601-2541
(574) 335-8220
Mailing address
32252 CHICAGO TRL, NEW CARLISLE, IN 46552-8101
(574) 292-1267
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
13004627A
IN
Other
Enumeration date
05/01/2019
Last updated
05/01/2019
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