Provider Demographics
NPI:1962594069
Name:KATHRYN STURM DDS PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:KATHRYN STURM DDS PROFESSIONAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:RAPPELD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:504-891-7471
Mailing Address - Street 1:6120 MAGAZINE ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70118
Mailing Address - Country:US
Mailing Address - Phone:504-891-7471
Mailing Address - Fax:504-891-8919
Practice Address - Street 1:6120 MAGAZINE ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70118
Practice Address - Country:US
Practice Address - Phone:504-891-7471
Practice Address - Fax:504-891-8919
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KRISTOPHER RAPPELD DDS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-28
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3385122300000X
LA5145122300000X
LA5430122300000X
LA5458122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty