Pottorf, Kelly G.
Pottorf, Kelly G. is an individual health care provider with primary practice located at 1717 Biddle St , Saint Louis MO 63106-3454. She recently has only one registered license in Dental Providers / Dental Hygienist, which is considered as her primary health care specialty. Pottorf, Kelly G. can be contacted via phone (314) 898-1717.Contact Information
Primary practice address
1717 Biddle St
Saint Louis MO 63106-3454
Phone: (314) 898-1717
Fax: (314) 814-8542
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dental Hygienist | 124Q00000X | 2009007073 | Missouri |
Profile Details
| NPI number | 1992008213 |
|---|---|
| LBN Legal business name | Pottorf, Kelly G. |
| Credentials | HYGIENST |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 8th, 2010 |
| Last updated | Dec 8th, 2010 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1992008213 | NPPES |
| Missouri | MEDICAID | 2009007073 |
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