Provider Demographics
NPI:1013076082
Name:CATER, DEAN ALAN (DDS)
Entity Type:Individual
Prefix:
First Name:DEAN
Middle Name:ALAN
Last Name:CATER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 LINCOLN HWY
Mailing Address - Street 2:
Mailing Address - City:ROCHELLE
Mailing Address - State:IL
Mailing Address - Zip Code:61068
Mailing Address - Country:US
Mailing Address - Phone:815-562-2030
Mailing Address - Fax:815-562-2030
Practice Address - Street 1:1001 LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:ROCHELLE
Practice Address - State:IL
Practice Address - Zip Code:61068
Practice Address - Country:US
Practice Address - Phone:815-562-2030
Practice Address - Fax:815-562-2030
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190153011223G0001X
332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment