Provider Demographics
NPI:1194874818
Name:MC KINLEY, CATHERINE BRIGID (BDENTSC)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:BRIGID
Last Name:MC KINLEY
Suffix:
Gender:F
Credentials:BDENTSC
Other - Prefix:MRS
Other - First Name:CATHERINE
Other - Middle Name:BRIGID
Other - Last Name:MAHON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BDENTSC
Mailing Address - Street 1:9876 DOS CERROS LOOP E
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-5100
Mailing Address - Country:US
Mailing Address - Phone:830-981-8978
Mailing Address - Fax:
Practice Address - Street 1:8221 FREDERICKSBURG RD
Practice Address - Street 2:SEVILLE OFFICE PARK
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3355
Practice Address - Country:US
Practice Address - Phone:210-614-3334
Practice Address - Fax:210-614-3331
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX194661223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry