Provider Demographics
NPI:1861651135
Name:HOTALING, KATHERINE ANNE (DDS)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:ANNE
Last Name:HOTALING
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 1:10007 KENNERLY RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-2179
Mailing Address - Country:US
Mailing Address - Phone:314-842-0440
Mailing Address - Fax:314-849-5847
Practice Address - Street 1:10007 KENNERLY RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-2179
Practice Address - Country:US
Practice Address - Phone:314-842-0440
Practice Address - Fax:314-849-5847
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008014156122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist