Provider Demographics
NPI:1194217638
Name:MCTIGUE, KATHRYN DAVIS (DDS)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:DAVIS
Last Name:MCTIGUE
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:ELAINE
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:385 S COLUMBIA ST RM 432
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-4309
Mailing Address - Country:US
Mailing Address - Phone:919-445-0323
Mailing Address - Fax:919-537-3990
Practice Address - Street 1:385 S COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-4309
Practice Address - Country:US
Practice Address - Phone:919-445-0323
Practice Address - Fax:919-537-3990
Is Sole Proprietor?:No
Enumeration Date:2018-05-31
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11007122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist