Provider Demographics
NPI:1790993103
Name:SANTJER, KATHY LYNN (DDS)
Entity Type:Individual
Prefix:DR
First Name:KATHY
Middle Name:LYNN
Last Name:SANTJER
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 1:35A COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:RUGBY
Mailing Address - State:ND
Mailing Address - Zip Code:58368-2507
Mailing Address - Country:US
Mailing Address - Phone:701-776-6153
Mailing Address - Fax:
Practice Address - Street 1:201 7TH ST SW
Practice Address - Street 2:SUITE #1
Practice Address - City:RUGBY
Practice Address - State:ND
Practice Address - Zip Code:58368-2100
Practice Address - Country:US
Practice Address - Phone:701-776-5884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDPENDING122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist