MEDICARE: DR. DAVID JOSEPH KURTZ 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	1223G0001X	General Practice Dentistry	051978	NY

General Provider Information

NPI Number	:	1790860229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID JOSEPH KURTZ DDS

Provider Business Mailing Address
First Line	:	2718 OCEAN AVE
Second Line	:	STE A4
City	:	BROOKLYN
State	:	NY
Zip	:	11229-4651
Country	:	US
Telephone Number	:	718-332-8404
Fax Number	:	718-332-1454

Provider Business Practice Location Address
First Line	:	340 MADISON AVE
Second Line	:	SUITE 4C
City	:	NEW YORK
State	:	NY
Zip	:	10173
Country	:	US
Telephone Number	:	646-216-8188
Fax Number	:

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

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	03/18/2016

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