Provider Demographics
NPI:1639144025
Name:KANWETZ, CATHERINE C (DDS)
Entity Type:Individual
Prefix:MISS
First Name:CATHERINE
Middle Name:C
Last Name:KANWETZ
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 1:3368 BELFORD RD
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-5005
Mailing Address - Country:US
Mailing Address - Phone:775-788-4514
Mailing Address - Fax:775-788-9369
Practice Address - Street 1:1776 NATIONAL GUARD WAY
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-4415
Practice Address - Country:US
Practice Address - Phone:775-788-4514
Practice Address - Fax:775-788-9369
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2547122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist