Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | DS028977L | PA |
NPI | 1053341164 |
---|---|
Provider Name | Dr. Andrew L Kanter |
First Address | Bryn Mawr, PA 19010-3201 |
Second Address | Bryn Mawr, PA 19010-3201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U71785 | (02) | PA |