Provider Demographics
NPI:1871787713
Name:BICKLEY, CATHERINE WALSH (DDS)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:WALSH
Last Name:BICKLEY
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 1:511 CARPENTER AVE
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28115-2511
Mailing Address - Country:US
Mailing Address - Phone:704-664-5311
Mailing Address - Fax:704-664-4794
Practice Address - Street 1:511 CARPENTER AVE
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28115-2511
Practice Address - Country:US
Practice Address - Phone:704-664-5311
Practice Address - Fax:704-664-4794
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-04
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6026122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist