Provider Demographics
NPI:1578618401
Name:KATSUR, WILLIAM JOHN (DMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JOHN
Last Name:KATSUR
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 MCMURRAY RD
Mailing Address - Street 2:SUITE 100A
Mailing Address - City:UPPER ST CLAIR
Mailing Address - State:PA
Mailing Address - Zip Code:15241-1633
Mailing Address - Country:US
Mailing Address - Phone:412-831-9910
Mailing Address - Fax:412-831-9962
Practice Address - Street 1:61 MCMURRAY RD
Practice Address - Street 2:SUITE 100A
Practice Address - City:UPPER ST CLAIR
Practice Address - State:PA
Practice Address - Zip Code:15241-1633
Practice Address - Country:US
Practice Address - Phone:412-831-9910
Practice Address - Fax:412-831-9962
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-018636-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice