Provider Demographics
NPI:1538908843
Name:NEUSETZER, CATHERINE WETHEY (DDS)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:WETHEY
Last Name:NEUSETZER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MS
Other - First Name:CATHERINE
Other - Middle Name:LIDDON
Other - Last Name:WETHEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:37290 OLD PERKINS RD
Mailing Address - Street 2:
Mailing Address - City:PRAIRIEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70769-3764
Mailing Address - Country:US
Mailing Address - Phone:225-960-5115
Mailing Address - Fax:
Practice Address - Street 1:37290 OLD PERKINS RD
Practice Address - Street 2:
Practice Address - City:PRAIRIEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70769-3764
Practice Address - Country:US
Practice Address - Phone:225-960-5115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-24
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7538122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty