Provider Demographics
NPI:1417198078
Name:VINCER SEARS, KATIE MARIE (DDS)
Entity Type:Individual
Prefix:MS
First Name:KATIE
Middle Name:MARIE
Last Name:VINCER SEARS
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 1:4147 N HIGH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3001
Mailing Address - Country:US
Mailing Address - Phone:614-263-0300
Mailing Address - Fax:614-263-7914
Practice Address - Street 1:4147 N HIGH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3001
Practice Address - Country:US
Practice Address - Phone:614-263-0300
Practice Address - Fax:614-263-7914
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-11
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0228211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice