Healthcare Provider Details

I. General information

NPI: 1972021145
Provider Name (Legal Business Name): CATHERINE G CAGINO DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2017
Last Update Date: 10/23/2023
Certification Date: 10/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 GREELEY ST STE 11
MERRIMACK NH
03054-4460
US

IV. Provider business mailing address

22 GREELEY ST STE 11
MERRIMACK NH
03054-4460
US

V. Phone/Fax

Practice location:
  • Phone: 716-544-2322
  • Fax:
Mailing address:
  • Phone: 716-544-2322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number33151
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: