Provider Demographics
NPI:1699802058
Name:RAYMOND, KATHERINE I (DDS)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:I
Last Name:RAYMOND
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4322 CLEVELAND MASSILLON RD
Mailing Address - Street 2:
Mailing Address - City:NORTON
Mailing Address - State:OH
Mailing Address - Zip Code:44203-5718
Mailing Address - Country:US
Mailing Address - Phone:330-825-4446
Mailing Address - Fax:330-825-4447
Practice Address - Street 1:4322 CLEVELAND MASSILLON RD
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:OH
Practice Address - Zip Code:44203-5718
Practice Address - Country:US
Practice Address - Phone:330-825-4446
Practice Address - Fax:330-825-4447
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH19734122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist