Provider Demographics
NPI:1093778771
Name:FERMELIA, CATHERINE A (DDS)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:A
Last Name:FERMELIA
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 1:3405 S YARROW ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80227-4965
Mailing Address - Country:US
Mailing Address - Phone:303-987-2121
Mailing Address - Fax:303-996-8501
Practice Address - Street 1:3405 S YARROW ST
Practice Address - Street 2:SUITE B
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80227-4965
Practice Address - Country:US
Practice Address - Phone:303-987-2121
Practice Address - Fax:303-996-8501
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO60641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice