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NPI Code Detail

MEDICARE: DR. WILLIAM LANE HURTT D.M.D.

MEDICARE: DR. WILLIAM LANE HURTT D.M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry043249NY

General Provider Information

NPI Number : 1093872319
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM LANE HURTT D.M.D.
Provider Business Mailing Address
First Line : 1580 ELMWOOD AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14620-3620
Country : US
Telephone Number : 585-271-1229
Fax Number : 585-271-1550
Provider Business Practice Location Address
First Line : 1580 ELMWOOD AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14620-3620
Country : US
Telephone Number : 585-271-1229
Fax Number : 585-271-1550
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2007
Last Update Date : 07/08/2007

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