Provider Demographics
NPI:1326161571
Name:KATZ, CANDACE LEVY (DMD)
Entity Type:Individual
Prefix:DR
First Name:CANDACE
Middle Name:LEVY
Last Name:KATZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 BIRCH RD
Mailing Address - Street 2:
Mailing Address - City:LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01106-3204
Mailing Address - Country:US
Mailing Address - Phone:413-754-3011
Mailing Address - Fax:
Practice Address - Street 1:10 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:EAST LONGMEADOW
Practice Address - State:MA
Practice Address - Zip Code:01028-2420
Practice Address - Country:US
Practice Address - Phone:413-525-0955
Practice Address - Fax:413-517-0003
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA213131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice