Provider Demographics
NPI:1215624382
Name:MCDOWELL, KATELYN MAE (DMD)
Entity type:Individual
Prefix:DR
First Name:KATELYN
Middle Name:MAE
Last Name:MCDOWELL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 GEM CT
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-6196
Mailing Address - Country:US
Mailing Address - Phone:270-401-1551
Mailing Address - Fax:
Practice Address - Street 1:14425 W MCDOWELL RD STE F106
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395-2516
Practice Address - Country:US
Practice Address - Phone:623-925-8208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-19
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD012189122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist