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General NPI Number Information
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NPI Number | 1790248904
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Entity Type | Individual
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Provider Name | KURTIS PAUL HUSSEY DMD
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Gender | Male
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Dates
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Enumeration Date | 04/13/2019
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Last Update Date | 08/19/2022
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Provider Practice Location Address
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Address Line | 1001 10TH AVE S
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City | NAPLES
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State | FL
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Zip | 34102-8237
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Country | US
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Telephone | 239-566-2255
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Fax | 239-566-1788
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Provider Business Mailing Address
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Address Line | 621 E VALLEY DR
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City | BONITA SPRINGS
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State | FL
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Zip | 34134-7432
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Country | US
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Telephone | 239-682-2149
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN23809
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License Number State | FL
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