Provider Demographics
NPI:1306013040
Name:KATZ, LEON DAVID (DDS)
Entity Type:Individual
Prefix:
First Name:LEON
Middle Name:DAVID
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 1:6210 PARK HEIGHTS AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-3626
Mailing Address - Country:US
Mailing Address - Phone:410-764-7341
Mailing Address - Fax:410-764-2638
Practice Address - Street 1:6210 PARK HEIGHTS AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-3626
Practice Address - Country:US
Practice Address - Phone:410-764-7341
Practice Address - Fax:410-764-2638
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMD61551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice