NPI 1386414068

Michelle Ann Klupp, RDH

Practitioner Dental Hygienist Great Lakes, IL

Practice location

Address: 2410 Sampson St, Great Lakes, IL 60088-2942
Phone: (847) 688-3331
Mailing address: 2832 Raymond Ave, Franksville, WI 53126-9641

Registered specialties

Dental Hygienist Primary

Dental Providers Taxonomy 124Q00000X Licence 3065-16 (WI)

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Registry record

NPI: 1386414068
Entity type: Individual
Sex (as registered): Female
NPI issued: 4 Jan 2024
Record last updated: 4 Jan 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.