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NPI Code Detail

MEDICARE: DR. KATERINA SIOUTIS DMD

MEDICARE: DR. KATERINA SIOUTIS DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryDS036971PA

General Provider Information

NPI Number : 1184985640
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATERINA SIOUTIS DMD
Provider Business Mailing Address
First Line : 1319 LINCOLN AVE
Second Line : PO BOX 254
City : PROSPECT PARK
State : PA
Zip : 19076-1216
Country : US
Telephone Number : 610-532-5008
Fax Number : 610-532-2459
Provider Business Practice Location Address
First Line : 1319 LINCOLN AVE
Second Line :
City : PROSPECT PARK
State : PA
Zip : 19076-1216
Country : US
Telephone Number : 610-532-5008
Fax Number : 610-532-2459
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2012
Last Update Date : 05/31/2012

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Directions to “ DR. KATERINA SIOUTIS DMD” Practice Location

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