Provider Demographics
NPI:1003962754
Name:KANTOR, PHILIP S (DMD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:S
Last Name:KANTOR
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:673 MORGANZA RD
Mailing Address - Street 2:
Mailing Address - City:CANONSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15317-5715
Mailing Address - Country:US
Mailing Address - Phone:724-746-3360
Mailing Address - Fax:724-746-3361
Practice Address - Street 1:673 MORGANZA RD
Practice Address - Street 2:
Practice Address - City:CANONSBURG
Practice Address - State:PA
Practice Address - Zip Code:15317-5715
Practice Address - Country:US
Practice Address - Phone:724-746-3360
Practice Address - Fax:724-746-3361
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS017777L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice