Provider Demographics
NPI:1386799153
Name:POEPPERLING, KATHERINE WEZMAR (DMD)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:WEZMAR
Last Name:POEPPERLING
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:MAUREEN
Other - Last Name:WEZMAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:900 SCHECHTER DRIVE
Mailing Address - Street 2:
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18702
Mailing Address - Country:US
Mailing Address - Phone:570-822-4181
Mailing Address - Fax:570-208-4984
Practice Address - Street 1:900 SCHECHTER DRIVE
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702
Practice Address - Country:US
Practice Address - Phone:570-822-4181
Practice Address - Fax:570-208-4984
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0363241223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry