Provider Demographics
NPI:1245688548
Name:ANTHONY J. KAIL, D.D.S. INC.
Entity type:Organization
Organization Name:ANTHONY J. KAIL, D.D.S. INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:J
Authorized Official - Last Name:KAIL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:724-206-0589
Mailing Address - Street 1:124 W CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-4423
Mailing Address - Country:US
Mailing Address - Phone:724-206-0589
Mailing Address - Fax:724-993-4197
Practice Address - Street 1:124 W CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-4423
Practice Address - Country:US
Practice Address - Phone:724-206-0589
Practice Address - Fax:724-993-4197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-26
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0381361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102492703Medicaid