Healthcare Provider Details

I. General information

NPI: 1104990100
Provider Name (Legal Business Name): WILLIAM Z. SPATZ D.M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 12/12/2023
Certification Date: 12/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2017 MURRAY AVE
PGH PA
15217
US

IV. Provider business mailing address

2017 MURRAY AVE
PGH PA
15217
US

V. Phone/Fax

Practice location:
  • Phone: 412-521-0965
  • Fax: 412-521-0965
Mailing address:
  • Phone: 412-521-0965
  • Fax: 412-521-0966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDP000526
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS035180
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDP000526
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: