Dr. Nicolette Taylor Kollath, DDS
Dentist, General Practice in Green Bay, WI. Individual provider (NPI-1).
NPI number1982196317
StatusActive
Last updated in NPPESJul 17, 2023
Details
- NPI
- 1982196317
- Entity type
- Individual (NPI-1)
- Name
- Dr. Nicolette Taylor Kollath
- Credential
- DDS
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 1, 2018
- Certification date
- Jul 17, 2023
- Last updated
- Jul 17, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | D14028 | MN | Yes |
| 1223G0001X | Dentist, General Practice | 6001156-15 | WI |
Other names
- Nicolette Taylor Klucas (Former Name)
Practice location
704 S. Webster Ave #402Green Bay, WI 54301
Phone 920-432-6894
Mailing address
704 S. Webster Ave #402Green Bay, WI 54301
Phone 612-508-7862
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