Provider Demographics
NPI:1255465183
Name:KURT K. WEBER, D.D.S., P.A.
Entity Type:Organization
Organization Name:KURT K. WEBER, D.D.S., P.A.
Other - Org Name:A BEAUTIFUL SMILE FOR YOU
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KURT
Authorized Official - Middle Name:KENTON
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:727-867-3400
Mailing Address - Street 1:5901 SUN BLVD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33715-1166
Mailing Address - Country:US
Mailing Address - Phone:727-867-3400
Mailing Address - Fax:813-653-4990
Practice Address - Street 1:5901 SUN BLVD
Practice Address - Street 2:SUITE 115
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33715-1166
Practice Address - Country:US
Practice Address - Phone:727-867-3400
Practice Address - Fax:813-653-4990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10991261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental