Provider Demographics
NPI:1447480678
Name:SLOCUM, KATHERINE A SIMS (DDS)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:A SIMS
Last Name:SLOCUM
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 1:307 E PARK AVE
Mailing Address - Street 2:SUITE 308
Mailing Address - City:ANACONDA
Mailing Address - State:MT
Mailing Address - Zip Code:59711-2320
Mailing Address - Country:US
Mailing Address - Phone:406-563-3473
Mailing Address - Fax:406-563-7557
Practice Address - Street 1:307 E PARK AVE
Practice Address - Street 2:SUITE 308
Practice Address - City:ANACONDA
Practice Address - State:MT
Practice Address - Zip Code:59711-2320
Practice Address - Country:US
Practice Address - Phone:406-563-3473
Practice Address - Fax:406-563-7557
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-22
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2359122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist