Provider Demographics
NPI:1326303462
Name:KUZMA, ANDREW P (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:P
Last Name:KUZMA
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 1:715 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DURYEA
Mailing Address - State:PA
Mailing Address - Zip Code:18642-1327
Mailing Address - Country:US
Mailing Address - Phone:570-457-0770
Mailing Address - Fax:570-457-0770
Practice Address - Street 1:715 MAIN ST
Practice Address - Street 2:
Practice Address - City:DURYEA
Practice Address - State:PA
Practice Address - Zip Code:18642-1327
Practice Address - Country:US
Practice Address - Phone:570-457-0770
Practice Address - Fax:570-457-0770
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-04
Last Update Date:2012-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS025679L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist