Provider Demographics
NPI:1497990386
Name:KATSUR, JAMES T (DMD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:T
Last Name:KATSUR
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:926 GREAT POND DR
Mailing Address - Street 2:SUITE 2003
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-7244
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:407-788-3572
Practice Address - Street 1:1597 WASHINGTON PIKE
Practice Address - Street 2:SUITE A-5
Practice Address - City:BRIDGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15017-2881
Practice Address - Country:US
Practice Address - Phone:412-279-4800
Practice Address - Fax:412-279-7119
Is Sole Proprietor?:No
Enumeration Date:2008-12-08
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PADS019993122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0005449700020Medicaid