Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | DN1855030 | MA |
NPI | 1033446901 |
---|---|
Provider Name | Dr. Catherine Kalis |
First Address | Natick, MA 01760-4323 |
Second Address | Natick, MA 01760-4323 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/11/2009 |
Last Update Date | 12/11/2009 |