Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 00010724 | CO |
NPI | 1083006357 |
---|---|
Provider Name | Dr. Kathryn Mccaa Hiegert |
First Address | Parker, CO 80138-3872 |
Second Address | Parker, CO 80138-3872 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2015 |
Last Update Date | 25/09/2017 |