Provider Demographics
NPI:1831578244
Name:PRESTON, KATHRYN (DDS)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:
Last Name:PRESTON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:124 W THOMAS RD STE 320
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-4415
Mailing Address - Country:US
Mailing Address - Phone:602-406-3560
Mailing Address - Fax:602-406-2770
Practice Address - Street 1:124 W THOMAS RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-4414
Practice Address - Country:US
Practice Address - Phone:602-933-0500
Practice Address - Fax:602-933-4320
Is Sole Proprietor?:No
Enumeration Date:2015-05-19
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZD0112061223X0400X, 1223X0400X
TX303261223X0400X
KY101911223X0400X
CA1010431223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics