MEDICARE: KURT A. ASCHIM DDS

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
1	122300000X	Dentist	2906	WI

General Provider Information

NPI Number	:	1609023894
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KURT A. ASCHIM DDS

Provider Business Mailing Address
First Line	:	2005 MARINETTE AVE
Second Line	:
City	:	MARINETTE
State	:	WI
Zip	:	54143-3864
Country	:	US
Telephone Number	:	715-732-2601
Fax Number	:	715-732-2677

Provider Business Practice Location Address
First Line	:	2005 MARINETTE AVE
Second Line	:
City	:	MARINETTE
State	:	WI
Zip	:	54143-3864
Country	:	US
Telephone Number	:	715-732-2601
Fax Number	:	715-732-2677

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2008
Last Update Date	:	08/19/2008

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