Dr. Walter Joseph Kucaba
Periodontist
151 Dillon Dr
Spartanburg
, South Carolina 29307-1017
Dr. Walter Joseph Kucaba
Periodontist
151 Dillon Dr
Spartanburg
, South Carolina 29307-1017
(864) 585-0469
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About
Features
Specialties
- Periodontist
Languages spoken
- English
Location
First Address
- Dr. Walter Joseph Kucaba
- 151 Dillon Dr
- Spartanburg, SC
- Zip : 29307-1017
- Fax : (864) 585-0469
- Phone : (864) 585-0468
Second Address
- Dr. Walter Joseph Kucaba
- 151 Dillon Dr
- Spartanburg, SC
- Zip : 29307-1017
- Fax : (864) 585-0469
- Phone : (864) 585-0468
Reviews
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0300X | Periodontist | 0218 PERIO | SC |
National Provider Identifier
| NPI | 1124083043 |
|---|---|
| Provider Name | Dr. Walter Joseph Kucaba |
| First Address | Spartanburg, SC 29307-1017 |
| Second Address | Spartanburg, SC 29307-1017 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 20/04/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0218 PERIO | SPECIALITY LICENSE (01) | SC |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.