Healthcare Provider Details

I. General information

NPI: 1326704982
Provider Name (Legal Business Name): KATHERINE HARTE DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2021
Last Update Date: 04/24/2023
Certification Date: 04/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1528 KINNIKINNICK ST APT A
ANCHORAGE AK
99508-3084
US

IV. Provider business mailing address

1528 KINNIKINNICK ST APT A
ANCHORAGE AK
99508-3084
US

V. Phone/Fax

Practice location:
  • Phone: 319-471-3807
  • Fax:
Mailing address:
  • Phone: 319-471-3807
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number182194
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number182194
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: