Provider Demographics
NPI:1053406009
Name:KATHY J GURSKI DMD & MARK A D'AGOSTINO DMD, PC
Entity type:Organization
Organization Name:KATHY J GURSKI DMD & MARK A D'AGOSTINO DMD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES./TREAS.
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:GURSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-796-2120
Mailing Address - Street 1:600 HIGH BLVD
Mailing Address - Street 2:SUITE E
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19607-2155
Mailing Address - Country:US
Mailing Address - Phone:610-796-2120
Mailing Address - Fax:610-796-2160
Practice Address - Street 1:600 HIGH BLVD
Practice Address - Street 2:SUITE E
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19607-2155
Practice Address - Country:US
Practice Address - Phone:610-796-2120
Practice Address - Fax:610-796-2160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty