Provider Demographics
NPI:1508816109
Name:AASEN, KATHRYN LOUISE (DDS)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:LOUISE
Last Name:AASEN
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 1:1127 N CORONA ST
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-2503
Mailing Address - Country:US
Mailing Address - Phone:719-632-2362
Mailing Address - Fax:
Practice Address - Street 1:2355 B FACULTY DRIVE
Practice Address - Street 2:10TH DS
Practice Address - City:USAF ACADEMY
Practice Address - State:CO
Practice Address - Zip Code:80840-8200
Practice Address - Country:US
Practice Address - Phone:319-333-5190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD73281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice