Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 256 | CA |
NPI | 1023246337 |
---|---|
Provider Name | Sandra D. Katz |
First Address | Beverly Hills, CA 90212-3609 |
Second Address | Beverly Hills, CA 90212-3609 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2009 |
Last Update Date | 24/06/2009 |