Individual
KEVIN J RISKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
326 PORTLAND PL, LITITZ, PA 17543-7705
(717) 320-4963
Mailing address
326 PORTLAND PL, LITITZ, PA 17543-7705
(717) 320-4963
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS039293
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102770945
—
PA
Enumeration date
10/04/2006
Last updated
09/11/2024
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