Healthcare Provider Details

I. General information

NPI: 1578207627
Provider Name (Legal Business Name): CATHERINE N ESCOFFIER DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2022
Last Update Date: 09/07/2023
Certification Date: 09/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BUILDING 99
APO AP
96319
US

IV. Provider business mailing address

PSC 76 BOX 4823
APO AP
96319-0049
US

V. Phone/Fax

Practice location:
  • Phone: 315-226-6700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN27077
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: