Individual
DR. CATHERINE N PERIOLAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4626 W JEFFERSON BLVD, FORT WAYNE, IN 46804-6897
(260) 432-0561
(260) 436-4626
Mailing address
4626 W JEFFERSON BLVD, FORT WAYNE, IN 46804-6897
(260) 432-0561
(260) 436-4626
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9882
IN
Other
Enumeration date
10/23/2007
Last updated
10/23/2007
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