Provider Demographics
NPI:1255499547
Name:HUETHER, KURTIS STEVEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:KURTIS
Middle Name:STEVEN
Last Name:HUETHER
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:PO BOX 156
Mailing Address - Street 2:3715 BRIDGE ST NW
Mailing Address - City:ST FRANCIS
Mailing Address - State:MN
Mailing Address - Zip Code:55070
Mailing Address - Country:US
Mailing Address - Phone:763-753-1900
Mailing Address - Fax:763-753-4220
Practice Address - Street 1:3715 BRIDGE ST NW
Practice Address - Street 2:
Practice Address - City:ST FRANCIS
Practice Address - State:MN
Practice Address - Zip Code:55070
Practice Address - Country:US
Practice Address - Phone:763-753-1900
Practice Address - Fax:763-753-4220
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND11497122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist