Healthcare Provider Details

I. General information

NPI: 1497820369
Provider Name (Legal Business Name): KATERINA AMELIA ROBINSON DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 12/15/2020
Certification Date: 12/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1315 US HIGHWAY 2 W
KALISPELL MT
59901-3413
US

IV. Provider business mailing address

1315 US HIGHWAY 2 W
KALISPELL MT
59901-3413
US

V. Phone/Fax

Practice location:
  • Phone: 406-890-6364
  • Fax: 406-890-6198
Mailing address:
  • Phone: 406-890-6364
  • Fax: 406-890-6198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number8792
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number7755
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: