Provider Demographics
NPI:1710940036
Name:KATZ, RICHARD D (DDS ; PA)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:D
Last Name:KATZ
Suffix:
Gender:M
Credentials:DDS ; PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 OLD SOLOMONS ISLAND RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3850
Mailing Address - Country:US
Mailing Address - Phone:410-266-8250
Mailing Address - Fax:
Practice Address - Street 1:43 OLD SOLOMONS ISLAND RD
Practice Address - Street 2:SUITE 103
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3850
Practice Address - Country:US
Practice Address - Phone:410-266-8250
Practice Address - Fax:410-266-1025
Is Sole Proprietor?:No
Enumeration Date:2006-04-08
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD62621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice