Provider Demographics
NPI:1174365324
Name:ATIENZA, CATIA (DDS)
Entity type:Individual
Prefix:DR
First Name:CATIA
Middle Name:
Last Name:ATIENZA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1704 SWAGOSA DR
Mailing Address - Street 2:
Mailing Address - City:MAQUOKETA
Mailing Address - State:IA
Mailing Address - Zip Code:52060-3316
Mailing Address - Country:US
Mailing Address - Phone:563-357-6653
Mailing Address - Fax:
Practice Address - Street 1:2ND DENTAL BATTALION
Practice Address - Street 2:PSC BOX 20130
Practice Address - City:FPO
Practice Address - State:AA
Practice Address - Zip Code:28542-0125
Practice Address - Country:US
Practice Address - Phone:910-467-3930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADDS-10213122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist