Individual
KATHLEEN DOYLE-KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
570 FOND DU LAC AVE, FOND DU LAC, WI 54935-5442
(920) 907-1400
(920) 907-1300
Mailing address
570 FOND DU LAC AVE, FOND DU LAC, WI 54935-5442
(920) 907-1400
(920) 907-1300
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4211
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
U81344
UPIN
WI
Enumeration date
01/20/2014
Last updated
09/20/2016
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