DR. Katherine Anne Divine, D.D.S.

NPI #1487093704 in Meridian, Idaho

Provider Information

NPI Number: 1487093704
Entity Type: Individual
Name: DR. Katherine Anne Divine, D.D.S.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Credential: D.D.S.
Enumeration Date: Jun 19, 2013
Last Updated: Jun 19, 2013

Practice Location

Address: 1311 E CENTRAL DR
City: Meridian
State: Idaho
ZIP Code: 83642-7991
Phone: (208) 373-1860

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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