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Individual

DR. KATHARINE MARIE MCGINNIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.M.D.

Contact information

Practice address
915 N MAIN ST, SUITE 3, COLUMBIA, IL 62236-1136
(618) 281-6161
Mailing address
1212 VICTOR ST, SAINT LOUIS, MO 63104-4326
(314) 771-3909

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
2003015422
MO
1223G0001X
General Practice Dentistry
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1005634
IL
Enumeration date
02/20/2007
Last updated
07/09/2007
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