Provider Demographics
NPI:1245221878
Name:KATZ, DAVID ALLEN (DDS)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ALLEN
Last Name:KATZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2934 TEXAS AVE
Mailing Address - Street 2:STE 1
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55426
Mailing Address - Country:US
Mailing Address - Phone:952-935-7727
Mailing Address - Fax:952-935-7728
Practice Address - Street 1:2934 TEXAS AVE
Practice Address - Street 2:STE 1
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55426
Practice Address - Country:US
Practice Address - Phone:952-935-7727
Practice Address - Fax:952-935-7728
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND9350122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist