Kristal Sue Wilmes
Dentist, General Practice in Tyler, MN. Individual provider (NPI-1).
NPI number1982194098
StatusActive
Last updated in NPPESMay 14, 2018
Details
- NPI
- 1982194098
- Entity type
- Individual (NPI-1)
- Name
- Kristal Sue Wilmes
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 14, 2018
- Last updated
- May 14, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | D13982 | MN | Yes |
Practice location
197 N Tyler StTyler, MN 56178-1160
Phone 507-380-0127
Mailing address
197 N Tyler StTyler, MN 56178-1160
Phone 507-380-0127
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