Healthcare Provider Details

I. General information

NPI: 1609865229
Provider Name (Legal Business Name): MARTY L. CATHEY D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/17/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 TYSON AVE SUITE A
PARIS TN
38242-4821
US

IV. Provider business mailing address

405 TYSON AVE SUITE A
PARIS TN
38242-4821
US

V. Phone/Fax

Practice location:
  • Phone: 731-642-2244
  • Fax: 731-644-9532
Mailing address:
  • Phone: 731-642-2244
  • Fax: 731-644-9532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS3928
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: