MEDICARE: DR. CATHERINE AKRIDGE 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
1	122300000X	Dentist	4290	AR

General Provider Information

NPI Number	:	1922593433
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CATHERINE AKRIDGE DDS

Provider Business Mailing Address
First Line	:	82 SOUTHWINDS RD
Second Line	:
City	:	FARMINGTON
State	:	AR
Zip	:	72730-8660
Country	:	US
Telephone Number	:	479-267-4900
Fax Number	:

Provider Business Practice Location Address
First Line	:	82 SOUTHWINDS RD
Second Line	:
City	:	FARMINGTON
State	:	AR
Zip	:	72730-8660
Country	:	US
Telephone Number	:	479-267-4900
Fax Number	:

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

Provider Enumeration Date	:	06/27/2018
Last Update Date	:	06/27/2018

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