Kiersten Micael Boehm Masello, DDS

NPI #1922637636 in Baxter, Minnesota

Provider Information

NPI Number: 1922637636
Entity Type: Individual
Name: Kiersten Micael Boehm Masello, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: Apr 4, 2020
Last Updated: Jul 15, 2020

Practice Location

Address: 14199 EDGEWOOD DR
City: Baxter
State: Minnesota
ZIP Code: 56425-8462
Phone: (651) 587-6846

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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