Provider Demographics
NPI:1942387121
Name:LAND, CATHERINE CELESTE (DMD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:CELESTE
Last Name:LAND
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 1:3017 POPLAR LEVEL RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40217-2300
Mailing Address - Country:US
Mailing Address - Phone:502-454-3307
Mailing Address - Fax:502-454-3472
Practice Address - Street 1:3017 POPLAR LEVEL RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40217-2300
Practice Address - Country:US
Practice Address - Phone:502-454-3307
Practice Address - Fax:502-454-3472
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY72451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice