Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 037680 | NY |
NPI | 1063581171 |
---|---|
Provider Name | Dr. Kenneth S Kurtz |
First Address | Ossining, NY 10562-1967 |
Second Address | Bronx, NY 10467-2401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2006 |
Last Update Date | 08/07/2007 |