Provider Demographics
NPI:1407173768
Name:DAVID J. KRZAN D.M.D., P.C.
Entity Type:Organization
Organization Name:DAVID J. KRZAN D.M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:KRZAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:724-443-1331
Mailing Address - Street 1:4949 WILLIAM FLYNN HWY
Mailing Address - Street 2:
Mailing Address - City:GIBSONIA
Mailing Address - State:PA
Mailing Address - Zip Code:15044-8405
Mailing Address - Country:US
Mailing Address - Phone:724-443-1331
Mailing Address - Fax:724-443-1508
Practice Address - Street 1:4949 WILLIAM FLYNN HWY
Practice Address - Street 2:
Practice Address - City:GIBSONIA
Practice Address - State:PA
Practice Address - Zip Code:15044-8405
Practice Address - Country:US
Practice Address - Phone:724-443-1331
Practice Address - Fax:724-443-1508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-27
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS028148L251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health