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General NPI Number Information
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NPI Number | 1871665232
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Entity Type | Individual
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Provider Name | DAVID JAMES HURT D.M.D, M.S.
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Gender | Male
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1201 S VETERANS PKWY STE E
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City | SPRINGFIELD
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State | IL
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Zip | 62704-6342
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Country | US
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Telephone | 217-793-9001
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Fax | 217-793-9188
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Provider Business Mailing Address
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Address Line | 7941 TOLAN RD
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City | PLEASANT PLAINS
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State | IL
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Zip | 62677-3956
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Country | US
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Telephone | 217-626-1389
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Fax | 217-793-9188
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State | IL
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