Provider Demographics
NPI:1306042361
Name:GUILD, KATHRYN MORLEY (DDS)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:MORLEY
Last Name:GUILD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:KATHRYN
Other - Middle Name:C
Other - Last Name:MORLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:PO BOX 459
Mailing Address - Street 2:2692 SOUTH STRAITS HIGHWAY
Mailing Address - City:INDIAN RIVER
Mailing Address - State:MI
Mailing Address - Zip Code:49749-0459
Mailing Address - Country:US
Mailing Address - Phone:231-238-9346
Mailing Address - Fax:231-238-0369
Practice Address - Street 1:2692 SOUTH STRAITS HIGHWAY
Practice Address - Street 2:
Practice Address - City:INDIAN RIVER
Practice Address - State:MI
Practice Address - Zip Code:49749-0459
Practice Address - Country:US
Practice Address - Phone:231-238-9346
Practice Address - Fax:231-238-0369
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010195621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice