Provider Demographics
NPI:1457697393
Name:RHODES HACKETT, KATHERINE (DDS)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:
Last Name:RHODES HACKETT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:
Other - Last Name:RHODES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2099 WISTERIA CIR
Mailing Address - Street 2:
Mailing Address - City:MACUNGIE
Mailing Address - State:PA
Mailing Address - Zip Code:18062-9337
Mailing Address - Country:US
Mailing Address - Phone:610-823-2267
Mailing Address - Fax:
Practice Address - Street 1:979 BROOKSIDE RD
Practice Address - Street 2:
Practice Address - City:WESCOSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18106
Practice Address - Country:US
Practice Address - Phone:610-395-1630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-21
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS039344122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist