Provider Demographics
NPI:1487770509
Name:THOMAS, KATHERINE GARRETT (DDS)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:GARRETT
Last Name:THOMAS
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 1:158 FRONT ROYAL PIKE
Mailing Address - Street 2:SUITE 311
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22602-4346
Mailing Address - Country:US
Mailing Address - Phone:540-665-0918
Mailing Address - Fax:
Practice Address - Street 1:158 FRONT ROYAL PIKE
Practice Address - Street 2:SUITE 311
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22602-4346
Practice Address - Country:US
Practice Address - Phone:540-665-0918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010079971223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics