Healthcare Provider Details

I. General information

NPI: 1205051356
Provider Name (Legal Business Name): DOUGLAS J. KATZ, DMD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 HOOKSETT RD
HOOKSETT NH
03106-1842
US

IV. Provider business mailing address

1310 HOOKSETT RD
HOOKSETT NH
03106-1842
US

V. Phone/Fax

Practice location:
  • Phone: 603-628-2891
  • Fax:
Mailing address:
  • Phone: 603-628-2891
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1396771523
Identifier TypeOTHER
Identifier StateNH
Identifier IssuerNPI # FOR INDIVIDUAL DMD

VIII. Authorized Official

Name: DR. DOUGLAS J. KATZ
Title or Position: PRESIDENT
Credential: D.M.D.
Phone: 603-628-2891