Provider Demographics
NPI:1215131255
Name:KATZ, ALLAN CLIFFORD (DDS)
Entity type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:CLIFFORD
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 1:866 HATHAWAY COURT
Mailing Address - Street 2:
Mailing Address - City:NORTH AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60542
Mailing Address - Country:US
Mailing Address - Phone:630-907-1741
Mailing Address - Fax:630-907-1742
Practice Address - Street 1:866 HATHAWAY COURT
Practice Address - Street 2:
Practice Address - City:NORTH AURORA
Practice Address - State:IL
Practice Address - Zip Code:60542
Practice Address - Country:US
Practice Address - Phone:630-907-1741
Practice Address - Fax:630-907-1742
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL19A142211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice