Provider Demographics
NPI:1104833680
Name:KIRSCH, ANN MARIE
Entity Type:Individual
Prefix:DR
First Name:ANN MARIE
Middle Name:
Last Name:KIRSCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 957
Mailing Address - Street 2:10317 PERRY HWY.
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-0957
Mailing Address - Country:US
Mailing Address - Phone:724-934-6260
Mailing Address - Fax:724-935-7161
Practice Address - Street 1:10317 PERRY HWY.
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-0957
Practice Address - Country:US
Practice Address - Phone:724-934-6260
Practice Address - Fax:724-935-7161
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-026975-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice