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General NPI Number Information
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NPI Number | 1316770670
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Entity Type | Organization
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Legal Business Name | KURT R. KWIATKOWSKI, DDS, SC
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Dates
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Enumeration Date | 08/22/2024
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Last Update Date | 08/30/2024
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Provider Practice Location Address
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Address Line | 1200 17TH AVE
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City | GRAFTON
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State | WI
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Zip | 53024-2004
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Country | US
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Telephone | 262-377-0852
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 17TH AVE
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City | GRAFTON
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State | WI
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Zip | 53024-2004
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Country | US
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Telephone | 262-377-0852
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | BELLA ZARITSKY
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Credential |
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Telephone | 480-590-3396
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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