Provider Demographics
NPI:1194947820
Name:KRZAN, DAVID J (DMD)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:J
Last Name:KRZAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:DAVID
Other - Middle Name:J
Other - Last Name:KRZAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:4949 WILLIAM FLYNN HWY
Mailing Address - Street 2:
Mailing Address - City:GIBSONIA
Mailing Address - State:PA
Mailing Address - Zip Code:15044-8405
Mailing Address - Country:US
Mailing Address - Phone:724-443-1331
Mailing Address - Fax:724-443-1508
Practice Address - Street 1:4949 WILLIAM FLYNN HWY
Practice Address - Street 2:
Practice Address - City:GIBSONIA
Practice Address - State:PA
Practice Address - Zip Code:15044-8405
Practice Address - Country:US
Practice Address - Phone:724-443-1331
Practice Address - Fax:724-443-1508
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-028148-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice