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General NPI Number Information
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NPI Number | 1245487909
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Entity Type | Individual
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Provider Name | KURTIS ANDREW KACER D.M.D., M.S.
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Gender | Male
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Dates
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Enumeration Date | 08/25/2008
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Last Update Date | 01/13/2010
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Provider Practice Location Address
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Address Line | 150 N PANTANO RD SUITE 100
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City | TUCSON
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State | AZ
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Zip | 85710-1401
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Country | US
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Telephone | 520-290-8787
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Fax |
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Provider Business Mailing Address
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Address Line | 150 N PANTANO RD SUITE 100
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City | TUCSON
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State | AZ
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Zip | 85710-1401
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Country | US
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Telephone | 520-290-8787
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 054255-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | D7679
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License Number State | AZ
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