MEDICARE: ANTHONY D KUPRIONAS DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry	DS019157L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275685315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY D KUPRIONAS DDS

Provider Business Mailing Address
First Line	:	1073 OAK ST
Second Line	:
City	:	PITTSTON
State	:	PA
Zip	:	18640-3716
Country	:	US
Telephone Number	:	570-654-4141
Fax Number	:	570-654-2150

Provider Business Practice Location Address
First Line	:	1073 OAK ST
Second Line	:
City	:	PITTSTON
State	:	PA
Zip	:	18640-3716
Country	:	US
Telephone Number	:	570-654-4141
Fax Number	:	570-654-2150

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/17/2007
Last Update Date	:	02/01/2016

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