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NPI 1710048707

NPI 1710048707 : KEVIN M STREZO DDS : HOMER CITY, PA

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General NPI Number Information
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    NPI Number           |    1710048707
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    Entity Type          |    Individual 
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    Provider Name        |    KEVIN M STREZO DDS
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    12/13/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    234 S MAIN ST 
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    City                 |    HOMER CITY
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    State                |    PA
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    Zip                  |    15748-1560
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    Country              |    US
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    Telephone            |    724-479-8071
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    Fax                  |    724-479-4271
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Provider Business Mailing Address
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    Address Line         |    234 S MAIN ST 
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    City                 |    HOMER CITY
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    State                |    PA
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    Zip                  |    15748-1560
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    Country              |    US
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    Telephone            |    724-479-8071
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    Fax                  |    724-479-4271
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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        |    1223G0001X
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    Taxonomy Name        |    General Practice Dentistry
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    License Number       |    DS022773-L
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    License Number State |    PA
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