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General NPI Number Information
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NPI Number | 1518487263
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Entity Type | Individual
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Provider Name | KATARINA KLEMENTINA FOSTER D.D.S
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Gender | Female
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Dates
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Enumeration Date | 06/23/2017
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Last Update Date | 06/05/2018
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Provider Practice Location Address
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Address Line | 16138 PILOT KNOB RD
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City | LAKEVILLE
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State | MN
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Zip | 55044
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Country | US
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Telephone | 952-679-7779
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Fax |
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Provider Business Mailing Address
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Address Line | 6582 157TH ST W APT 110B
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City | APPLE VALLEY
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State | MN
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Zip | 55124-6057
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Country | US
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Telephone | 414-305-9752
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 1001616
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D13914
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License Number State | MN
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