MEDICARE: DR. KATE BURKE CARTWRIGHT DMD

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
1	122300000X	Dentist	30.024009	OH

General Provider Information

NPI Number	:	1689916843
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATE BURKE CARTWRIGHT DMD

Provider Business Mailing Address
First Line	:	1063 S COURT ST
Second Line	:
City	:	MEDINA
State	:	OH
Zip	:	44256-2824
Country	:	US
Telephone Number	:	330-725-0581
Fax Number	:

Provider Business Practice Location Address
First Line	:	1063 S COURT ST
Second Line	:
City	:	MEDINA
State	:	OH
Zip	:	44256-2824
Country	:	US
Telephone Number	:	330-725-0581
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/26/2013
Last Update Date	:	03/26/2016

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