Provider Demographics
NPI:1497366561
Name:KATHERINE KHAGHANY DUFFY PLC
Entity Type:Organization
Organization Name:KATHERINE KHAGHANY DUFFY PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAGHANY DUFFY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:269-344-7222
Mailing Address - Street 1:465 S DRAKE RD
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-1216
Mailing Address - Country:US
Mailing Address - Phone:269-344-7222
Mailing Address - Fax:269-344-7227
Practice Address - Street 1:465 S DRAKE RD
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-1216
Practice Address - Country:US
Practice Address - Phone:269-344-7222
Practice Address - Fax:269-344-7227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-12
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental