Provider Demographics
NPI:1689613028
Name:MYRON E. KATZ, DMD, MSD, INC
Entity Type:Organization
Organization Name:MYRON E. KATZ, DMD, MSD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MYRON
Authorized Official - Middle Name:E
Authorized Official - Last Name:KATZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:918-749-6448
Mailing Address - Street 1:4543 S HARVARD AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-2905
Mailing Address - Country:US
Mailing Address - Phone:918-749-6448
Mailing Address - Fax:918-749-7300
Practice Address - Street 1:4543 S HARVARD AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-2905
Practice Address - Country:US
Practice Address - Phone:918-749-6448
Practice Address - Fax:918-749-7300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3438261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental