Provider Demographics
NPI:1003828930
Name:KNECHTEL, KURT WINSTON (DMD)
Entity Type:Individual
Prefix:
First Name:KURT
Middle Name:WINSTON
Last Name:KNECHTEL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1322 VIVIAN ST
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501
Mailing Address - Country:US
Mailing Address - Phone:303-776-4229
Mailing Address - Fax:303-776-4220
Practice Address - Street 1:1322 VIVIAN ST
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501
Practice Address - Country:US
Practice Address - Phone:720-815-4733
Practice Address - Fax:303-776-4220
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7353122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist