Provider Demographics
NPI:1023124179
Name:WURM, CATHERINE ELAINE (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:ELAINE
Last Name:WURM
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1521 NORTHWAY DR
Mailing Address - Street 2:SUITE 115
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-4489
Mailing Address - Country:US
Mailing Address - Phone:320-656-1456
Mailing Address - Fax:320-656-0195
Practice Address - Street 1:1521 NORTHWAY DR
Practice Address - Street 2:SUITE 115
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-4489
Practice Address - Country:US
Practice Address - Phone:320-656-1456
Practice Address - Fax:320-656-0195
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN110351223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics