Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 10021 | MN |
NPI | 1417097411 |
---|---|
Provider Name | Dr. Kimberly Kay Sturm |
First Address | Ashland, WI 54806-4272 |
Second Address | Ashland, WI 54806-4272 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2007 |
Last Update Date | 19/07/2016 |