Provider Demographics
NPI:1184669186
Name:ANUSZKIEWICZ, MARY ANN (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARY ANN
Middle Name:
Last Name:ANUSZKIEWICZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 THORN RUN ROAD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MOON TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:15108
Mailing Address - Country:US
Mailing Address - Phone:412-269-8950
Mailing Address - Fax:412-269-8950
Practice Address - Street 1:1150 THORN RUN ROAD
Practice Address - Street 2:SUITE 105
Practice Address - City:MOON TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:15108
Practice Address - Country:US
Practice Address - Phone:412-269-8950
Practice Address - Fax:412-269-8950
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS026759I122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist