Individual
DR. KENNETH D ANDRYC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
7686 W RIDGE RD, BOX 65, FAIRVIEW, PA 16415-1074
(814) 474-1527
(814) 474-5022
Mailing address
7686 W RIDGE RD, BOX 65, FAIRVIEW, PA 16415-1074
(814) 474-1527
(814) 474-5022
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS018928L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005084900001
—
PA
Enumeration date
10/18/2005
Last updated
12/27/2011
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