Provider Demographics
NPI:1679734149
Name:ALFIERIS, KATINA M (DDS)
Entity Type:Individual
Prefix:DR
First Name:KATINA
Middle Name:M
Last Name:ALFIERIS
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 1:1817 SHAW AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-4069
Mailing Address - Country:US
Mailing Address - Phone:559-325-1999
Mailing Address - Fax:559-325-0999
Practice Address - Street 1:1817 SHAW AVE STE 101
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-4069
Practice Address - Country:US
Practice Address - Phone:559-325-1999
Practice Address - Fax:559-325-0999
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-18
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA413381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice