Provider Demographics
NPI:1154543049
Name:KAISER, KRISTIN ELIZABETH (DDS)
Entity type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:ELIZABETH
Last Name:KAISER
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 1:63 LINDEN LN
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-2141
Mailing Address - Country:US
Mailing Address - Phone:419-350-6768
Mailing Address - Fax:
Practice Address - Street 1:401 W COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:PEMBERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43450-9495
Practice Address - Country:US
Practice Address - Phone:419-287-3205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH21852122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist