Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0106X | Oral and Maxillofacial Pathology | 17951 | TX |
N | 1223P0106X | Oral and Maxillofacial Pathology | 30-024363 | OH |
Y | 1223P0106X | Oral and Maxillofacial Pathology | DEN.00105371 | CO |
N | 1223P0221X | Pediatric Dentist | 30-024363 | OH |
NPI | 1962411827 |
---|---|
Provider Name | Dr. Catherine Mary Flaitz |
First Address | Denver, CO 80203-2664 |
Second Address | Denver, CO 80203 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2006 |
Last Update Date | 18/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0119665 | (05) | OH |
111084301 | (05) | TX |
89773B | BLUE CROSS BLUE SHIELD (01) | TX |
U65019 | (02) | TX |