Provider Demographics
NPI:1043441801
Name:LIGON, KATHY ALICIA (DDS)
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:ALICIA
Last Name:LIGON
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:NAVAL HOSPITAL OAK HBR
Mailing Address - Street 2:3475 N. SARATOGA ST.
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98278-8800
Mailing Address - Country:US
Mailing Address - Phone:360-257-9972
Mailing Address - Fax:360-257-9978
Practice Address - Street 1:NAVAL HOSPITAL OAK HBR
Practice Address - Street 2:3475 N. SARATOGA ST.
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98278-8800
Practice Address - Country:US
Practice Address - Phone:360-257-9972
Practice Address - Fax:360-257-9978
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-28
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60087411122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist