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NPI Code Detail

MEDICARE: DR. KEVIN DEAN HURSH D.D.S.

MEDICARE: DR. KEVIN DEAN HURSH D.D.S.
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 Dentistry49113CA

General Provider Information

NPI Number : 1134294820
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KEVIN DEAN HURSH D.D.S.
Provider Business Mailing Address
First Line : 160 CAPP ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94110-1210
Country : US
Telephone Number : 415-621-8056
Fax Number :
Provider Business Practice Location Address
First Line : 160 CAPP ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94110-1210
Country : US
Telephone Number : 415-621-8056
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2006
Last Update Date : 07/08/2007

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