Provider Demographics
NPI:1649161191
Name:LATULIP, KATIE ELIZABETH (RDH, IPDH)
Entity type:Individual
Prefix:MS
First Name:KATIE
Middle Name:ELIZABETH
Last Name:LATULIP
Suffix:
Gender:F
Credentials:RDH, IPDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 CYR RD
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:NH
Mailing Address - Zip Code:03561-3704
Mailing Address - Country:US
Mailing Address - Phone:603-366-6132
Mailing Address - Fax:
Practice Address - Street 1:238 NORTH ST
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-1870
Practice Address - Country:US
Practice Address - Phone:603-366-6132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERDH4663124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist