Provider Demographics
NPI:1023562972
Name:KATHERMAN, KAITLYN ANNE (DMD)
Entity Type:Individual
Prefix:DR
First Name:KAITLYN
Middle Name:ANNE
Last Name:KATHERMAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:KAITLYN
Other - Middle Name:ANNE
Other - Last Name:HUSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:450 WEST MARKET STREET
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17406
Mailing Address - Country:US
Mailing Address - Phone:717-757-4878
Mailing Address - Fax:
Practice Address - Street 1:450 W MARKET STREET
Practice Address - Street 2:
Practice Address - City:HALLAM
Practice Address - State:PA
Practice Address - Zip Code:17406
Practice Address - Country:US
Practice Address - Phone:717-757-4878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-09
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS040897122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist