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NPI Code Detail

MEDICARE: DR. KATHERINE CAROLINE KOTTAS DDS

MEDICARE: DR. KATHERINE CAROLINE KOTTAS 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 DentistryD11602MN

General Provider Information

NPI Number : 1932269388
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATHERINE CAROLINE KOTTAS DDS
Provider Business Mailing Address
First Line : 1327 W 58TH ST
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55419-2116
Country : US
Telephone Number : 612-866-1327
Fax Number :
Provider Business Practice Location Address
First Line : 1905 PLAZA DR
Second Line :
City : EAGAN
State : MN
Zip : 55122-2883
Country : US
Telephone Number : 651-686-6678
Fax Number : 651-686-5504
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2006
Last Update Date : 07/08/2007

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Directions to “ DR. KATHERINE CAROLINE KOTTAS DDS” Practice Location

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