Healthcare Provider Details

I. General information

NPI: 1427675677
Provider Name (Legal Business Name): CORY S KUYK DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2020
Last Update Date: 04/07/2022
Certification Date: 04/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 PATTON AVE
ASHEVILLE NC
28806-1721
US

IV. Provider business mailing address

PO BOX 2045
ABINGDON VA
24212-2045
US

V. Phone/Fax

Practice location:
  • Phone: 828-254-9692
  • Fax:
Mailing address:
  • Phone: 276-628-9507
  • Fax: 276-628-9439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number0401416977
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number12209
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: