Healthcare Provider Details

I. General information

NPI: 1386730489
Provider Name (Legal Business Name): CATER/GALANTE ORTHODONTIC SPECIALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10544 SPENCEVILLE RD
PENN VALLEY CA
95946-9623
US

IV. Provider business mailing address

10544 SPENCEVILLE RD
PENN VALLEY CA
95946-9623
US

V. Phone/Fax

Practice location:
  • Phone: 530-432-3483
  • Fax:
Mailing address:
  • Phone: 530-432-3483
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number40555
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number44877
License Number StateCA

VIII. Authorized Official

Name: MRS. JACKIE FITZHENRY
Title or Position: OFFICE MANAGER
Credential:
Phone: 530-432-3483