Provider Demographics
NPI:1215051057
Name:KATHEIN, LITAL (DDS)
Entity type:Individual
Prefix:
First Name:LITAL
Middle Name:
Last Name:KATHEIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 NW 100TH AVE
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-7034
Mailing Address - Country:US
Mailing Address - Phone:954-476-4537
Mailing Address - Fax:954-476-7734
Practice Address - Street 1:131 NW 100TH AVE
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-7034
Practice Address - Country:US
Practice Address - Phone:954-476-4537
Practice Address - Fax:954-476-7734
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 174911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice