Provider Demographics
NPI:1669685178
Name:HARTMAN, KRISTEN MARIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:MARIE
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3224 E LINDY LN
Mailing Address - Street 2:
Mailing Address - City:OAK CREEK
Mailing Address - State:WI
Mailing Address - Zip Code:53154-6542
Mailing Address - Country:US
Mailing Address - Phone:414-762-1889
Mailing Address - Fax:
Practice Address - Street 1:5007 S HOWELL AVE STE 315
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53207-6159
Practice Address - Country:US
Practice Address - Phone:414-483-1820
Practice Address - Fax:414-483-1821
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4805122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist