Individual
DR. JOSEPH KACZOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DS022361-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000060334
HIGHMARK BC/BS
PA
05
—
0019426300002
—
PA
Enumeration date
10/19/2006
Last updated
06/18/2009
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