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General NPI Number Information
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NPI Number | 1205024965
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Entity Type | Organization
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Legal Business Name | KURT M. HALUM, DMD, PC
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Dates
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Enumeration Date | 10/09/2007
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Last Update Date | 10/09/2007
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Provider Practice Location Address
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Address Line | 2303 45TH ST
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City | HIGHLAND
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State | IN
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Zip | 46322-2602
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Country | US
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Telephone | 219-924-5437
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Fax |
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Provider Business Mailing Address
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Address Line | 2303 45TH ST
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City | HIGHLAND
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State | IN
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Zip | 46322-2602
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Country | US
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Telephone | 219-924-5437
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. KURT M. HALUM
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Credential | DMD
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Telephone | 219-924-5437
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 12009620
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License Number State | IN
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