Provider Demographics
NPI:1578940375
Name:SATULA, KATIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:KATIE
Middle Name:
Last Name:SATULA
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:W198S10846 RACINE AVE
Mailing Address - Street 2:
Mailing Address - City:MUSKEGO
Mailing Address - State:WI
Mailing Address - Zip Code:53150-8457
Mailing Address - Country:US
Mailing Address - Phone:414-550-3525
Mailing Address - Fax:
Practice Address - Street 1:11801 W JANESVILLE RD STE 6
Practice Address - Street 2:
Practice Address - City:HALES CORNERS
Practice Address - State:WI
Practice Address - Zip Code:53130-2327
Practice Address - Country:US
Practice Address - Phone:414-425-1510
Practice Address - Fax:414-425-1861
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-30
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WI1001086 - 15122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program