Provider Demographics
NPI:1942476742
Name:K.D. ANDRYC DDS AND DENTAL ASSOCIATES PC
Entity Type:Organization
Organization Name:K.D. ANDRYC DDS AND DENTAL ASSOCIATES PC
Other - Org Name:WEST COUNTY DENTAL
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNTH
Authorized Official - Middle Name:D
Authorized Official - Last Name:ANDRYC
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:814-474-1527
Mailing Address - Street 1:7686 W RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:PA
Mailing Address - Zip Code:16415-1074
Mailing Address - Country:US
Mailing Address - Phone:814-474-1527
Mailing Address - Fax:814-474-5022
Practice Address - Street 1:7686 W RIDGE RD
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:PA
Practice Address - Zip Code:16415-1074
Practice Address - Country:US
Practice Address - Phone:814-474-1527
Practice Address - Fax:814-474-5022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS018928L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty