Provider Demographics
NPI:1063087583
Name:SOTKIEWICZ, KELSEY LEE (DDS)
Entity type:Individual
Prefix:DR
First Name:KELSEY
Middle Name:LEE
Last Name:SOTKIEWICZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:257 MILLVILLE OXFORD RD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-4476
Mailing Address - Country:US
Mailing Address - Phone:513-867-8459
Mailing Address - Fax:513-867-8409
Practice Address - Street 1:257 MILLVILLE OXFORD RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-4476
Practice Address - Country:US
Practice Address - Phone:513-867-8459
Practice Address - Fax:513-867-8409
Is Sole Proprietor?:No
Enumeration Date:2021-05-26
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.026518122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist