Provider Demographics
NPI:1982229183
Name:PLAGENZ, KATE (DMD)
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:
Last Name:PLAGENZ
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 1:91 RAINEY ST APT 406
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-0050
Mailing Address - Country:US
Mailing Address - Phone:715-492-0373
Mailing Address - Fax:
Practice Address - Street 1:3801 S CONGRESS AVE STE 106
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-8043
Practice Address - Country:US
Practice Address - Phone:512-641-4469
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-12
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36165122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist