Provider Demographics
NPI:1891895215
Name:MUHICH, KRISTIN KAY (RDH)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:KAY
Last Name:MUHICH
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:MISS
Other - First Name:KRISTIN
Other - Middle Name:KAY
Other - Last Name:MUHICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH
Mailing Address - Street 1:9646 HAMLET AVE S
Mailing Address - Street 2:
Mailing Address - City:COTTAGE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55016-3870
Mailing Address - Country:US
Mailing Address - Phone:651-276-6984
Mailing Address - Fax:
Practice Address - Street 1:1789 WOODLANE DR
Practice Address - Street 2:SUITE D
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-3910
Practice Address - Country:US
Practice Address - Phone:651-738-1284
Practice Address - Fax:651-738-0072
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4869124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist