Provider Demographics
NPI:1598785446
Name:LAW, KATHERINE
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:
Last Name:LAW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26741 PORTOLA PKWY
Mailing Address - Street 2:SUITE 1-D
Mailing Address - City:FOOTHILL RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92610-1743
Mailing Address - Country:US
Mailing Address - Phone:949-581-4908
Mailing Address - Fax:949-581-9071
Practice Address - Street 1:26741 PORTOLA PKWY
Practice Address - Street 2:SUITE 1-D
Practice Address - City:FOOTHILL RANCH
Practice Address - State:CA
Practice Address - Zip Code:92610-1743
Practice Address - Country:US
Practice Address - Phone:949-581-4908
Practice Address - Fax:949-581-9071
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA445071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice