Provider Demographics
NPI:1326498494
Name:KALB, KRISTINE MARIBELLE (RDH)
Entity Type:Individual
Prefix:MRS
First Name:KRISTINE
Middle Name:MARIBELLE
Last Name:KALB
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 RICHARDSON DR
Mailing Address - Street 2:BUILDING 634
Mailing Address - City:FORT RICHARDSON
Mailing Address - State:AK
Mailing Address - Zip Code:99505-8310
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:600 RICHARDSON DR
Practice Address - Street 2:BUILDING 634
Practice Address - City:FORT RICHARDSON
Practice Address - State:AK
Practice Address - Zip Code:99505-8310
Practice Address - Country:US
Practice Address - Phone:907-384-2483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-20
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK2179124Q00000X
AK804124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist