Provider Demographics
NPI:1487212817
Name:KNIER, KATHRYN TAYLOR (DDS)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:TAYLOR
Last Name:KNIER
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 1:201 MCCULLOUGH DR STE 180
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-1302
Mailing Address - Country:US
Mailing Address - Phone:704-790-4402
Mailing Address - Fax:
Practice Address - Street 1:201 MCCULLOUGH DR STE 180
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-1302
Practice Address - Country:US
Practice Address - Phone:704-790-4402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-31
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11404122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist