Provider Demographics
NPI:1962555664
Name:MCGRATH, KATHERINE ANNE (DDS, FAGD)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:ANNE
Last Name:MCGRATH
Suffix:
Gender:F
Credentials:DDS, FAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9679 MAIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-3766
Mailing Address - Country:US
Mailing Address - Phone:703-978-6556
Mailing Address - Fax:703-426-1405
Practice Address - Street 1:9679 MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-3766
Practice Address - Country:US
Practice Address - Phone:703-978-6556
Practice Address - Fax:703-426-1405
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010056361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice