Kirsten K Komarek, RDH

Individual provider Active NPI Dental Hygienist · Carlton, MN

NPI 1285245233 · NPPES record last updated Oct 18, 2021

Key facts

NPI
1285245233
Entity type
Individual (NPI type 1)
Primary specialty
Dental Hygienist 124Q00000X
License
H9686 (MN)
Practice address
210 3Rd St
Carlton, MN 55718-7703
Phone
(218) 336-3524
Fax
(218) 384-9002
NPI assigned
Aug 13, 2020
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
H9686MNMDDental Hygienist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X H9686 MN Yes

Addresses

Primary practice location

210 3Rd St
Carlton, MN 55718-7703

Mailing address

2222 E 5TH St
Superior, WI 54880-3709
Phone (715) 392-1955

Other practice location 1

4325 Grand Ave
Duluth, MN 55807-2730
Phone (218) 628-7035

Other providers in Carlton, MN

All providers in Carlton, MN · Dental Hygienist in Minnesota

Sources for this page

Verify at the official NPI Registry.