Provider Demographics
NPI:1306021167
Name:KREIDER, KATHRYN ANN (DMD)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:ANN
Last Name:KREIDER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9810 LAKEVIEW PKWY
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75088-4549
Mailing Address - Country:US
Mailing Address - Phone:214-703-5292
Mailing Address - Fax:
Practice Address - Street 1:9810 LAKEVIEW PKWY
Practice Address - Street 2:
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75088-4549
Practice Address - Country:US
Practice Address - Phone:214-703-5292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-28
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX192821223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry