Healthcare Provider Details

I. General information

NPI: 1528232410
Provider Name (Legal Business Name): CATEY DENTISTRY, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2008
Last Update Date: 04/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 S 2ND ST
GAS CITY IN
46933-1704
US

IV. Provider business mailing address

115 S 2ND ST
GAS CITY IN
46933-1704
US

V. Phone/Fax

Practice location:
  • Phone: 765-674-7241
  • Fax: 765-674-6570
Mailing address:
  • Phone: 765-674-7241
  • Fax: 765-674-6570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number9658
License Number StateIN

VIII. Authorized Official

Name: DR. MARA CATEY-WILLIAMS
Title or Position: OWNER
Credential: D.M.D.
Phone: 765-674-7241