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Organization
KATZ FAMILY DENTAL LLC
Active
Organization
KATZ FAMILY DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER S KATZ DMD (OWNER)
(860) 521-0594
Entity
Organization
Contact information
Practice address
125 LASALLE RD, SUITE 306, WEST HARTFORD, CT 06107-2322
(860) 521-0594
(860) 521-7568
Mailing address
125 LASALLE RD, SUITE 306, WEST HARTFORD, CT 06107-2322
(860) 521-0594
(860) 521-7568
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
005151
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20515144093
—
CT
Enumeration date
03/15/2012
Last updated
03/15/2012
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