Provider Demographics
NPI:1912164021
Name:CATLIN-FRIEDRICH, KIRSTIN ANN (DENTAL HYGIENIST)
Entity type:Individual
Prefix:
First Name:KIRSTIN
Middle Name:ANN
Last Name:CATLIN-FRIEDRICH
Suffix:
Gender:F
Credentials:DENTAL HYGIENIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4242 PARK VIEW DR
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53546-2146
Mailing Address - Country:US
Mailing Address - Phone:608-754-6915
Mailing Address - Fax:
Practice Address - Street 1:4242 PARK VIEW DR
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53546-2146
Practice Address - Country:US
Practice Address - Phone:608-754-6915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-18
Last Update Date:2008-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5087-16124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist