Provider Demographics
NPI:1710390968
Name:PASS, CATHERINE (DDS)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:
Last Name:PASS
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 1:22 N EUCLID AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108-1407
Mailing Address - Country:US
Mailing Address - Phone:913-544-5080
Mailing Address - Fax:
Practice Address - Street 1:22 N EUCLID AVE STE 220
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-1407
Practice Address - Country:US
Practice Address - Phone:314-361-0760
Practice Address - Fax:314-367-7726
Is Sole Proprietor?:No
Enumeration Date:2014-06-05
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014015541122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist