# KATERINA SIOUTIS DMD, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Media Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568839827
- **Authorized official:** MR. DEAN KANELLOPOULOS (OFFICE MANAGER)
- **Authorized official phone:** (610) 566-3600

## Contact information

- **Practice address:** 415 E BALTIMORE AVE STE 2, MEDIA, PA 19063-3538
- **Practice address phone:** (610) 566-3600
- **Mailing address:** 415 E BALTIMORE AVE STE 2, MEDIA, PA 19063-3538
- **Mailing address phone:** (610) 566-3600

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |
| 124Q00000X | Dental Hygienist | — | NULL | — |
| 124Q00000X | Dental Hygienist | — | — | — |
| 126800000X | Dental Assistant | — | NULL | — |
| 126800000X | Dental Assistant | — | — | — |

## Other

- **Enumeration date:** 08/21/2015
- **Last updated:** 08/21/2015