Healthcare Provider Details

I. General information

NPI: 1316909401
Provider Name (Legal Business Name): W. CALVIN KIER DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/04/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 N GREENGATE RD SUITE 310
GREENSBURG PA
15601-6394
US

IV. Provider business mailing address

926 GREAT POND DR SUITE 2003
ALTAMONTE SPRINGS FL
32714-7244
US

V. Phone/Fax

Practice location:
  • Phone: 724-853-2355
  • Fax: 724-853-0935
Mailing address:
  • Phone: 407-772-5124
  • Fax: 407-788-3572

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS016734
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: