Provider Demographics
NPI:1578051173
Name:MILLINDER, KATHRINE ELISE (RDH)
Entity Type:Individual
Prefix:
First Name:KATHRINE
Middle Name:ELISE
Last Name:MILLINDER
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4133 ALLPORT CUTOFF
Mailing Address - Street 2:
Mailing Address - City:MORRISDALE
Mailing Address - State:PA
Mailing Address - Zip Code:16858-7323
Mailing Address - Country:US
Mailing Address - Phone:814-761-0213
Mailing Address - Fax:
Practice Address - Street 1:439 SPRING ST
Practice Address - Street 2:
Practice Address - City:HOUTZDALE
Practice Address - State:PA
Practice Address - Zip Code:16651-1702
Practice Address - Country:US
Practice Address - Phone:814-378-7006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-29
Last Update Date:2018-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADH071657124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist