Individual
MR. ANDREW KYLE BURZYNSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LD
Contact information
Practice address
853 NE 4TH ST., BEND, OR 97701
(541) 389-7485
Mailing address
853 NE 4TH ST., BEND, OR 97701
(541) 389-7485
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
DT-DO-10190716
OR
Other
Enumeration date
01/02/2020
Last updated
01/02/2020
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