Provider Demographics
NPI:1558305599
Name:KATZ, MARK D (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:D
Last Name:KATZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8605 CAMINO MEDIA
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-1355
Mailing Address - Country:US
Mailing Address - Phone:661-665-0077
Mailing Address - Fax:661-665-0009
Practice Address - Street 1:8605 CAMINO MEDIA
Practice Address - Street 2:SUITE 200
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-1355
Practice Address - Country:US
Practice Address - Phone:661-665-0077
Practice Address - Fax:661-665-0009
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA276381223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics