Provider Demographics
NPI:1386140218
Name:PIASKOWSKI, CATHERINE ANNE (DDS)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:ANNE
Last Name:PIASKOWSKI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MS
Other - First Name:CATHERINE
Other - Middle Name:ANNE
Other - Last Name:SCHRICKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:5716 MICHIGAN AVE.
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48210
Mailing Address - Country:US
Mailing Address - Phone:313-554-0485
Mailing Address - Fax:313-228-0283
Practice Address - Street 1:5716 MICHIGAN AVE.
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48210
Practice Address - Country:US
Practice Address - Phone:313-554-3880
Practice Address - Fax:313-899-3550
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-31
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901600893122300000X, 1223G0001X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentistGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty