Provider Demographics
NPI:1154442135
Name:FURY, KIM A (DDS)
Entity Type:Individual
Prefix:DR
First Name:KIM
Middle Name:A
Last Name:FURY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:KIM
Other - Middle Name:
Other - Last Name:FURY-SLATEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:16716 CHILLICOTHE RD
Mailing Address - Street 2:SUITE 700
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44023-4595
Mailing Address - Country:US
Mailing Address - Phone:440-708-0900
Mailing Address - Fax:440-708-0904
Practice Address - Street 1:16716 CHILLICOTHE RD
Practice Address - Street 2:SUITE 700
Practice Address - City:CHAGRIN FALLS
Practice Address - State:OH
Practice Address - Zip Code:44023-4595
Practice Address - Country:US
Practice Address - Phone:440-708-0900
Practice Address - Fax:440-708-0904
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300200901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice