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DR. KASEY MARIE STARK DDS
General Practice >> Dentist >> Dental ProvidersRegistrant NPI Number: 1477083855
Individual Registrant:DR. KASEY MARIE STARK DDS
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
380 N STATE RD OTISVILLE, MI 48463-9486 US
Tel: 810-631-4524 Fax: --
Tel: 810-631-4524 Fax: --
Contact information for business:
631 E KIRBY ST DETROIT, MI 48202-4122 US
Tel: 810-252-6616 Fax: --
Tel: 810-252-6616 Fax: --
Registration Information:
NPI: 1477083855
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 1223G0001X | Dental Providers Dentist General Practice | MI | 2901022317 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
