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General NPI Number Information
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NPI Number | 1508416967
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Entity Type | Organization
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Legal Business Name | ERIC HURTTE D.M.D, P.C.
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Dates
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Enumeration Date | 09/18/2019
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Last Update Date | 09/19/2019
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Provider Practice Location Address
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Address Line | 7766 WINGHAVEN BLVD
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City | O FALLON
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State | MO
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Zip | 63368-3601
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Country | US
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Telephone | 636-561-4117
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Fax |
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Provider Business Mailing Address
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Address Line | 749 CLARK RD
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City | EOLIA
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State | MO
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Zip | 63344-2321
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Country | US
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Telephone | 636-734-7879
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Fax |
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Authorized Official
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Title or Position | FRONT DESK
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Name | KIRSTEN BURKEMPER
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Credential |
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Telephone | 636-561-4117
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number |
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License Number State |
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