Provider Demographics
NPI:1760817159
Name:PARET, KATHERINE (DMD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:
Last Name:PARET
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 1:61 OCEAN VIEW AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-3010
Mailing Address - Country:US
Mailing Address - Phone:207-747-7369
Mailing Address - Fax:
Practice Address - Street 1:225 WATERMAN DR
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-3634
Practice Address - Country:US
Practice Address - Phone:207-200-4106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-05
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDEN4418122300000X
SCDGD.8275 GD122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist