Disterhoft, Kali Rose
Disterhoft, Kali Rose is an individual health care provider with primary practice located at 33 E Waldo Blvd , Manitowoc WI 54220-2900. She recently has only one registered license in Dental Providers / Dentist, which is considered as her primary health care specialty. Disterhoft, Kali Rose can be contacted via phone (920) 682-0115.Contact Information
Primary practice address
33 E Waldo Blvd
Manitowoc WI 54220-2900
Phone: (920) 682-0115
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | DDS-09919 | Iowa |
| Dental Providers / Dentist | 122300000X | 1002654-15 | Wisconsin |
Profile Details
| NPI number | 1962073577 |
|---|---|
| LBN Legal business name | Disterhoft, Kali Rose |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 6th, 2021 |
| Last updated | Jul 25th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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