Provider Demographics
NPI:1366441271
Name:MINTON, KATHRYN L (DDS)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:L
Last Name:MINTON
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 1:5072 W PLANO PKWY
Mailing Address - Street 2:SUITE 250
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-4476
Mailing Address - Country:US
Mailing Address - Phone:972-818-1300
Mailing Address - Fax:972-818-1301
Practice Address - Street 1:5072 W PLANO PKWY
Practice Address - Street 2:SUITE 250
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-4476
Practice Address - Country:US
Practice Address - Phone:972-818-1300
Practice Address - Fax:972-818-1301
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX142261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice