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NPI Code Detail

MEDICARE: KATHERINE ROSE VAUGHAN DDS

MEDICARE: KATHERINE ROSE VAUGHAN DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryD13579MN
2122300000XDentistD13579MN

General Provider Information

NPI Number : 1619350006
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE ROSE VAUGHAN DDS
Provider Business Mailing Address
First Line : 400 4TH ST NW
Second Line :
City : FARIBAULT
State : MN
Zip : 55021-5089
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 400 4TH ST NW
Second Line :
City : FARIBAULT
State : MN
Zip : 55021-5089
Country : US
Telephone Number : 507-384-6830
Fax Number : 651-431-7757
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2015
Last Update Date : 12/16/2025

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Directions to “ KATHERINE ROSE VAUGHAN DDS” Practice Location

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