Provider Demographics
NPI:1891822201
Name:STURM, KATHRYN
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:
Last Name:STURM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6120 MAGAZINE ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70118-5826
Mailing Address - Country:US
Mailing Address - Phone:504-891-7471
Mailing Address - Fax:504-891-8919
Practice Address - Street 1:6120 MAGAZINE ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70118-5826
Practice Address - Country:US
Practice Address - Phone:504-891-7471
Practice Address - Fax:504-891-8919
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3385122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist