Provider Demographics
NPI:1811541501
Name:KATHOL, ALLISON KAY (DDS)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:KAY
Last Name:KATHOL
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 1:6290 S FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80121-2527
Mailing Address - Country:US
Mailing Address - Phone:605-760-0367
Mailing Address - Fax:
Practice Address - Street 1:1333 W 120TH AVE STE 314
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80234-2750
Practice Address - Country:US
Practice Address - Phone:303-452-2221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-31
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO00204050122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist