Provider Demographics
NPI:1407099260
Name:MCBRIDE, KATRINIA SUE (DDS)
Entity Type:Individual
Prefix:
First Name:KATRINIA
Middle Name:SUE
Last Name:MCBRIDE
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 1:1617 E MCCART ST STE 100
Mailing Address - Street 2:
Mailing Address - City:KRUM
Mailing Address - State:TX
Mailing Address - Zip Code:76249-5649
Mailing Address - Country:US
Mailing Address - Phone:940-482-6300
Mailing Address - Fax:940-482-6270
Practice Address - Street 1:1617 E MCCART ST STE 100
Practice Address - Street 2:
Practice Address - City:KRUM
Practice Address - State:TX
Practice Address - Zip Code:76249-5649
Practice Address - Country:US
Practice Address - Phone:940-482-6300
Practice Address - Fax:940-482-6270
Is Sole Proprietor?:No
Enumeration Date:2009-04-09
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX239601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice