Provider Demographics
NPI:1013358373
Name:DONLEY, KATHLEEN BAUM (DDS)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:BAUM
Last Name:DONLEY
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 1:395 STONE BLUFF LN
Mailing Address - Street 2:
Mailing Address - City:ALVATON
Mailing Address - State:KY
Mailing Address - Zip Code:42122-9721
Mailing Address - Country:US
Mailing Address - Phone:270-746-9110
Mailing Address - Fax:
Practice Address - Street 1:395 STONE BLUFF LN
Practice Address - Street 2:
Practice Address - City:ALVATON
Practice Address - State:KY
Practice Address - Zip Code:42122-9721
Practice Address - Country:US
Practice Address - Phone:270-746-9110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-15
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY7091122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist