Healthcare Provider Details

I. General information

NPI: 1790817054
Provider Name (Legal Business Name): ROBERT T KUZNE DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 SOUTH MAIN STREET PITTSTON DENTAL CENTER
PITTSTON PA
18640
US

IV. Provider business mailing address

RR2 BOX 2165
STROUDSBURG PA
18360
US

V. Phone/Fax

Practice location:
  • Phone: 570-654-2484
  • Fax:
Mailing address:
  • Phone: 570-424-7423
  • Fax: 570-424-7423

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS026789L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDI016279
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: