MEDICARE: DR. WILLIAM JOHN KATSUR D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DS-018636-L	PA

General Provider Information

NPI Number	:	1578618401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM JOHN KATSUR D.M.D.

Provider Business Mailing Address
First Line	:	61 MCMURRAY RD
Second Line	:	SUITE 100A
City	:	UPPER ST CLAIR
State	:	PA
Zip	:	15241-1633
Country	:	US
Telephone Number	:	412-831-9910
Fax Number	:	412-831-9962

Provider Business Practice Location Address
First Line	:	61 MCMURRAY RD
Second Line	:	SUITE 100A
City	:	UPPER ST CLAIR
State	:	PA
Zip	:	15241-1633
Country	:	US
Telephone Number	:	412-831-9910
Fax Number	:	412-831-9962

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2007
Last Update Date	:	07/08/2007

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