Provider Demographics
NPI:1356697049
Name:HART WESTPHAL, KATHERINE A (DDS, MDS)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:A
Last Name:HART WESTPHAL
Suffix:
Gender:F
Credentials:DDS, MDS
Other - Prefix:DR
Other - First Name:KATHERINE
Other - Middle Name:A
Other - Last Name:HART
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS, MDS
Mailing Address - Street 1:1849 MEMORIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-1522
Mailing Address - Country:US
Mailing Address - Phone:615-890-7246
Mailing Address - Fax:
Practice Address - Street 1:1849 MEMORIAL BLVD
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-1522
Practice Address - Country:US
Practice Address - Phone:615-890-7246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-31
Last Update Date:2016-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN90171223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics