Provider Demographics
NPI:1386791952
Name:MCDERMOTT, KATHLEEN RUTH (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:RUTH
Last Name:MCDERMOTT
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4907 SANDHILL DR STE B
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-5352
Mailing Address - Country:US
Mailing Address - Phone:281-277-3555
Mailing Address - Fax:281-277-3571
Practice Address - Street 1:4907 SANDHILL DR STE B
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-5352
Practice Address - Country:US
Practice Address - Phone:281-277-3555
Practice Address - Fax:281-277-3571
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX143661223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics