Provider Demographics
NPI:1366417941
Name:KC DENARDO DMD PC
Entity type:Organization
Organization Name:KC DENARDO DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER OF CORPORATION
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:C
Authorized Official - Last Name:DENARDO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD MSD
Authorized Official - Phone:412-264-3499
Mailing Address - Street 1:200 COMMERCE DR
Mailing Address - Street 2:#203
Mailing Address - City:MOON TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:15108
Mailing Address - Country:US
Mailing Address - Phone:412-264-3499
Mailing Address - Fax:412-264-3524
Practice Address - Street 1:200 COMMERCE DR
Practice Address - Street 2:#203
Practice Address - City:MOON TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:15108
Practice Address - Country:US
Practice Address - Phone:412-264-3499
Practice Address - Fax:412-264-3524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS019867L1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty