Provider Demographics
NPI:1578585436
Name:ARNER, KIRK A (DMD)
Entity Type:Individual
Prefix:DR
First Name:KIRK
Middle Name:A
Last Name:ARNER
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 1:106 N MARKET ST
Mailing Address - Street 2:
Mailing Address - City:SUMMIT HILL
Mailing Address - State:PA
Mailing Address - Zip Code:18250-1108
Mailing Address - Country:US
Mailing Address - Phone:570-645-3252
Mailing Address - Fax:510-645-3252
Practice Address - Street 1:106 N MARKET ST
Practice Address - Street 2:
Practice Address - City:SUMMIT HILL
Practice Address - State:PA
Practice Address - Zip Code:18250-1108
Practice Address - Country:US
Practice Address - Phone:570-645-3252
Practice Address - Fax:510-645-3252
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-024720-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA154342OtherBLUE SHIELD PROVIDER #