Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | D07371 | AZ |
NPI | 1083814818 |
---|---|
Provider Name | Dr. Elizabeth Irene Katz |
First Address | Tucson, AZ 85716-5508 |
Second Address | Tucson, AZ 85711-5540 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2007 |
Last Update Date | 30/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
241148 | (05) | AZ |