Provider Demographics
NPI:1053313148
Name:KURTZ, BARRY D (DDS)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:D
Last Name:KURTZ
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 1:1951 BAY BLVD
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11509-1305
Mailing Address - Country:US
Mailing Address - Phone:516-239-3259
Mailing Address - Fax:
Practice Address - Street 1:5 BEACH 105TH ST
Practice Address - Street 2:
Practice Address - City:ROCKAWAY PARK
Practice Address - State:NY
Practice Address - Zip Code:11694-2699
Practice Address - Country:US
Practice Address - Phone:718-474-0007
Practice Address - Fax:718-474-0004
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024534-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice