KYLIE MIRANDA ANDERSON ADT
Individual Provider (NPI-1)
Active
Dental Therapist
Provider Information
- NPI Number
1225689060- Provider Type
- Individual Provider (NPI-1)
- Credentials
- ADT
- Status
- Active
Contact & Location
- Address
- 3650 BRADDOCK AVE NE, BUFFALO, MN, 553133672
- Phone
- (763) 270-6900
Specialties & Taxonomies
Dental Hygienist
License: MN #H10758
Dental Therapist
Primary License: MN #DT128