Provider Demographics
NPI:1043342942
Name:HUR, JAMES J (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:J
Last Name:HUR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1402 36TH ST SW
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:MI
Mailing Address - Zip Code:49509-3407
Mailing Address - Country:US
Mailing Address - Phone:616-534-3362
Mailing Address - Fax:616-261-8466
Practice Address - Street 1:1402 36TH ST SW
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:MI
Practice Address - Zip Code:49509-3407
Practice Address - Country:US
Practice Address - Phone:616-534-3362
Practice Address - Fax:616-261-8466
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI179351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice