Provider Demographics
NPI:1194984591
Name:CATALICO, CHRISTINE I (RDH)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:I
Last Name:CATALICO
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BAVARIA DENTAL ACTIVITY
Mailing Address - Street 2:CMR 475
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09036
Mailing Address - Country:US
Mailing Address - Phone:49931-889-7714
Mailing Address - Fax:49931-889-7718
Practice Address - Street 1:BAVARIA DENTAL ACTIVITY
Practice Address - Street 2:CMR 475
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09036
Practice Address - Country:US
Practice Address - Phone:49931-889-7714
Practice Address - Fax:49931-889-7718
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0402203831124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist