Provider Demographics
NPI:1962705178
Name:KATSURA, NEIL M (DDS)
Entity type:Individual
Prefix:
First Name:NEIL
Middle Name:M
Last Name:KATSURA
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Gender:M
Credentials:DDS
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Mailing Address - Street 1:3010 COLBY ST
Mailing Address - Street 2:217
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-2091
Mailing Address - Country:US
Mailing Address - Phone:510-848-6494
Mailing Address - Fax:510-981-1159
Practice Address - Street 1:3010 COLBY ST
Practice Address - Street 2:217
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-2091
Practice Address - Country:US
Practice Address - Phone:510-848-6494
Practice Address - Fax:510-981-1159
Is Sole Proprietor?:No
Enumeration Date:2010-12-09
Last Update Date:2010-12-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA0327281223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry