Provider Demographics
NPI:1376825893
Name:ASHLAND, KATERINA (DMD)
Entity Type:Individual
Prefix:DR
First Name:KATERINA
Middle Name:
Last Name:ASHLAND
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 1:44 HYDE AVE
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:CT
Mailing Address - Zip Code:06066-4503
Mailing Address - Country:US
Mailing Address - Phone:860-875-5050
Mailing Address - Fax:860-454-0190
Practice Address - Street 1:44 HYDE AVE
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:CT
Practice Address - Zip Code:06066-4503
Practice Address - Country:US
Practice Address - Phone:860-875-5050
Practice Address - Fax:860-454-0190
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0442000138122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist