Provider Demographics
NPI:1427542240
Name:YOUNG, CATHERINE ELIZABETH (DDS)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:ELIZABETH
Last Name:YOUNG
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 1:3231 N LOOP 1604 W APT 1109
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78257-4408
Mailing Address - Country:US
Mailing Address - Phone:979-451-5763
Mailing Address - Fax:
Practice Address - Street 1:16500 SAN PEDRO AVE STE 440
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-2295
Practice Address - Country:US
Practice Address - Phone:210-483-8888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-15
Last Update Date:2018-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX340961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice