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NPI Code Detail

MEDICARE: KENTON CHRISTOPHER ANDRYC

MEDICARE: KENTON CHRISTOPHER ANDRYC
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
1122300000XDentistDS040398PA

General Provider Information

NPI Number : 1619364353
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENTON CHRISTOPHER ANDRYC
Provider Business Mailing Address
First Line : 7686 W RIDGE RD
Second Line : FAIRVIEW
City : FAIRVIEW
State : PA
Zip : 16415-1074
Country : US
Telephone Number : 814-474-1527
Fax Number : 814-474-5022
Provider Business Practice Location Address
First Line : 7686 W RIDGE RD
Second Line : FAIRVIEW
City : FAIRVIEW
State : PA
Zip : 16415-1074
Country : US
Telephone Number : 814-474-1527
Fax Number : 814-474-5022
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2015
Last Update Date : 09/01/2015

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Directions to “ KENTON CHRISTOPHER ANDRYC ” Practice Location

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