Provider Demographics
NPI:1215355359
Name:STAHRR, KATHERINE (DDS)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:
Last Name:STAHRR
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 1:901 NW CARLON AVE
Mailing Address - Street 2:SUITE #1
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703-2636
Mailing Address - Country:US
Mailing Address - Phone:541-389-1884
Mailing Address - Fax:
Practice Address - Street 1:901 NW CARLON AVE
Practice Address - Street 2:SUITE #1
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-2636
Practice Address - Country:US
Practice Address - Phone:541-389-1884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-05
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
ORD103101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program