Provider Demographics
NPI:1699147843
Name:GEE, KARA MICHELLE (RDH, BS)
Entity type:Individual
Prefix:MRS
First Name:KARA
Middle Name:MICHELLE
Last Name:GEE
Suffix:
Gender:F
Credentials:RDH, BS
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:MICHELLE
Other - Last Name:THIBAULT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH, BS
Mailing Address - Street 1:1060 FAIRHOME RD
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48236
Mailing Address - Country:US
Mailing Address - Phone:586-883-0885
Mailing Address - Fax:
Practice Address - Street 1:6900 EAST 10 MILE RD.
Practice Address - Street 2:
Practice Address - City:CENTERLINE
Practice Address - State:MI
Practice Address - Zip Code:48015
Practice Address - Country:US
Practice Address - Phone:586-467-0980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-28
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2902015675124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist