Provider Demographics
NPI:1801399233
Name:PARFOMAK, KATHERINE (DDS)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:PARFOMAK
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 1:114 WESTFIELD RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-4819
Mailing Address - Country:US
Mailing Address - Phone:551-265-6452
Mailing Address - Fax:
Practice Address - Street 1:114 WESTFIELD RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-4819
Practice Address - Country:US
Practice Address - Phone:865-253-7288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-12
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN116491223G0001X
NJ22DI027733001223G0001X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program