Provider Demographics
NPI:1871572693
Name:KATZ, RAYMOND J (DDS)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:J
Last Name:KATZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38145 ANN ARBOR RD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-3466
Mailing Address - Country:US
Mailing Address - Phone:734-464-2000
Mailing Address - Fax:734-464-2040
Practice Address - Street 1:38145 ANN ARBOR RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-3466
Practice Address - Country:US
Practice Address - Phone:734-464-2000
Practice Address - Fax:734-464-2040
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI091731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice