Provider Demographics
NPI:1144304155
Name:KATZ, MICHAEL (DMD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:KATZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3048 BARBER LN
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-3249
Mailing Address - Country:US
Mailing Address - Phone:856-904-9475
Mailing Address - Fax:
Practice Address - Street 1:124 W MERCHANT ST
Practice Address - Street 2:SUITE A
Practice Address - City:AUDUBON
Practice Address - State:NJ
Practice Address - Zip Code:08106-1424
Practice Address - Country:US
Practice Address - Phone:856-547-9151
Practice Address - Fax:856-547-9152
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS024174L122300000X
NJ22DI014995021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice