Provider Demographics
NPI:1598116626
Name:POWERS, KATHARINE CECILY (DMD)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:CECILY
Last Name:POWERS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1186 BELL RD
Mailing Address - Street 2:
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44022-4122
Mailing Address - Country:US
Mailing Address - Phone:440-338-5667
Mailing Address - Fax:
Practice Address - Street 1:2124 CORNELL RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-3804
Practice Address - Country:US
Practice Address - Phone:216-368-8665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-30
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.24856122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist