Healthcare Provider Details

I. General information

NPI: 1508566381
Provider Name (Legal Business Name): CATHERINE ROSE WEBER CLARY DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2023
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 RUE FONTAINE
LAFAYETTE LA
70508-5744
US

IV. Provider business mailing address

113 RUE FONTAINE
LAFAYETTE LA
70508-5744
US

V. Phone/Fax

Practice location:
  • Phone: 337-233-2277
  • Fax:
Mailing address:
  • Phone: 337-233-2277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number0
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: