Provider Demographics
NPI:1891724761
Name:KATCH, ERIC M (DMD)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:M
Last Name:KATCH
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 1:1000 ROHRERSTOWN ROAD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2644
Mailing Address - Country:US
Mailing Address - Phone:717-519-5297
Mailing Address - Fax:717-519-5290
Practice Address - Street 1:1000 ROHRERSTOWN ROAD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2644
Practice Address - Country:US
Practice Address - Phone:717-519-5297
Practice Address - Fax:717-519-5290
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS026871L1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1047822OtherAMERIHEALTH MERCY
PA50000507OtherCAPITAL BLUE CROSS
PA0016853910001Medicaid
PA1685391Medicaid
PA7280056001OtherCIGNA
PAKA473131OtherHIGHMARK BLUE SHIELD
PAT87590Medicare UPIN
0000473131Medicare PIN
PAKA473131OtherHIGHMARK BLUE SHIELD
PA7280056001OtherCIGNA