Provider Demographics
NPI:1417570540
Name:CATER, RHETT MATHEW (DMD)
Entity Type:Individual
Prefix:DR
First Name:RHETT
Middle Name:MATHEW
Last Name:CATER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:894 E ROOSEVELT RD
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-4746
Mailing Address - Country:US
Mailing Address - Phone:630-932-0090
Mailing Address - Fax:630-932-0156
Practice Address - Street 1:894 E ROOSEVELT RD
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-4746
Practice Address - Country:US
Practice Address - Phone:630-932-0090
Practice Address - Fax:630-932-0156
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-23
Last Update Date:2020-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019032560122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty