| Joseph L Kaczor, Inc Pc | |
|
2606 Broad Ave. Altoona PA 16601-1915 | |
| (814) 944-6355 | |
| (814) 941-7324 |
| Full Name | Joseph L Kaczor, Inc Pc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 2606 Broad Ave., Altoona, Pennsylvania |
| Authorized Official Name and Position | Joseph Kaczor (PRESIDENT) |
| Authorized Official Contact | 8149446355 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Joseph L Kaczor, Inc Pc 2606 Broad Ave. Altoona PA 16601-1915 Ph: (814) 944-6355 | Joseph L Kaczor, Inc Pc 2606 Broad Ave. Altoona PA 16601-1915 Ph: (814) 944-6355 |
| NPI Number | 1346322799 |
|---|---|
| Provider Enumeration Date | 10/19/2006 |
| Last Update Date | 06/18/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346322799 | NPI | - | NPPES |
| 000060334 | Other | PA | HIGHMARK BC/BS |
| 0019426300002 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | DS022361-L (Pennsylvania) | Primary |
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