Provider Demographics
NPI:1063677177
Name:GEISLER, CATHERINE A (DDS)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:A
Last Name:GEISLER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:A
Other - Last Name:CALDERON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:1229 NAPOLEON
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:OH
Mailing Address - Zip Code:43420
Mailing Address - Country:US
Mailing Address - Phone:734-674-6697
Mailing Address - Fax:419-724-1651
Practice Address - Street 1:1642 RALSTON CIRCLE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-3801
Practice Address - Country:US
Practice Address - Phone:419-536-7265
Practice Address - Fax:419-724-1651
Is Sole Proprietor?:No
Enumeration Date:2008-07-29
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0228781223G0001X
OH30-022878122300000X
OH022878122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2848404Medicaid
OH30.022878OtherOH