Provider Demographics
NPI:1427451988
Name:KUEHL, SUSANNE (RDH)
Entity type:Individual
Prefix:
First Name:SUSANNE
Middle Name:
Last Name:KUEHL
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 HALEY RD
Mailing Address - Street 2:
Mailing Address - City:KITTERY
Mailing Address - State:ME
Mailing Address - Zip Code:03904-5402
Mailing Address - Country:US
Mailing Address - Phone:207-752-2968
Mailing Address - Fax:
Practice Address - Street 1:90 HALEY RD
Practice Address - Street 2:
Practice Address - City:KITTERY
Practice Address - State:ME
Practice Address - Zip Code:03904-5402
Practice Address - Country:US
Practice Address - Phone:207-752-2968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-29
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH00760124Q00000X
ME2809124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist