Dr. KALI ROSE DISTERHOFT
Individual Provider (NPI-1)
Active
Dentist
Provider Information
- NPI Number
1962073577- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 33 E WALDO BLVD, MANITOWOC, WI, 542202900
- Phone
- (920) 682-0115
Specialties & Taxonomies
Dentist
License: IA #DDS-09919
Dentist
Primary License: WI #1002654-15
All Addresses
MAILING
622 PENNSYLVANIA AVE UNIT 504
SHEBOYGAN, WI, 530814662