Provider Demographics
NPI:1922183383
Name:KATZMAN, MICHELLE BLOCH (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:BLOCH
Last Name:KATZMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:BLOCH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:100 STATE ST
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666
Mailing Address - Country:US
Mailing Address - Phone:201-837-3000
Mailing Address - Fax:201-837-0997
Practice Address - Street 1:100 STATE ST
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666
Practice Address - Country:US
Practice Address - Phone:201-837-3000
Practice Address - Fax:201-837-0997
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ16907122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist