Provider Demographics
NPI:1205018454
Name:KAZMERSKIDMD, DENNIS JAMES (DMD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:JAMES
Last Name:KAZMERSKIDMD
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 1:301 MOREA RD
Mailing Address - Street 2:
Mailing Address - City:FRACKVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17932-0001
Mailing Address - Country:US
Mailing Address - Phone:570-773-2158
Mailing Address - Fax:570-783-2002
Practice Address - Street 1:301 MOREA RD
Practice Address - Street 2:
Practice Address - City:FRACKVILLE
Practice Address - State:PA
Practice Address - Zip Code:17932-0001
Practice Address - Country:US
Practice Address - Phone:570-773-2158
Practice Address - Fax:570-783-2002
Is Sole Proprietor?:No
Enumeration Date:2007-11-29
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS029880L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist