Individual
KELLY HARNISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
740 S MAIN ST, CHEBOYGAN, MI 49721-2220
(231) 627-7118
(231) 627-1838
Mailing address
1035 W WASHINGTON AVE, ALPENA, MI 49707-2929
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2902012072
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2902012072
—
MI
Enumeration date
04/15/2019
Last updated
04/15/2019
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