Andryc, Kenneth D

Andryc, Kenneth D is an sole proprietor health care provider with primary practice located at 7686 W Ridge Rd Box 65, Fairview PA 16415-1074. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Andryc, Kenneth D can be contacted via phone (814) 474-1527.

Contact Information

Primary practice address
7686 W Ridge Rd Box 65 Fairview PA 16415-1074
Fax: (814) 474-5022
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X DS018928L Pennsylvania

Profile Details

NPI number 1598754921
LBN Legal business name Andryc, Kenneth D
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 18th, 2005
Last updated Dec 27th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598754921 NPPES
Pennsylvania MEDICAID 0005084900001

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