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General NPI Number Information
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NPI Number | 1942470539
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Entity Type | Organization
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Legal Business Name | MICHAEL A. KURKOWSKI, PA
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Dates
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Enumeration Date | 03/10/2008
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Last Update Date | 03/10/2008
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Provider Practice Location Address
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Address Line | 3500 RICE ST
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City | SAINT PAUL
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State | MN
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Zip | 55126-3043
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Country | US
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Telephone | 651-484-5331
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Fax |
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Provider Business Mailing Address
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Address Line | 3500 RICE ST
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City | SAINT PAUL
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State | MN
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Zip | 55126-3043
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Country | US
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Telephone | 651-484-5331
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. MICHAEL A KURKOWSKI
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Credential | DDS
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Telephone | 651-484-5331
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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 | 9278
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License Number State | MN
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