Provider Demographics
NPI:1326720038
Name:KURT R. HULSE, D.D.S., S.C.
Entity Type:Organization
Organization Name:KURT R. HULSE, D.D.S., S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KURT
Authorized Official - Middle Name:R
Authorized Official - Last Name:HULSE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:608-780-8818
Mailing Address - Street 1:1840 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ONALASKA
Mailing Address - State:WI
Mailing Address - Zip Code:54650-7709
Mailing Address - Country:US
Mailing Address - Phone:608-783-1306
Mailing Address - Fax:608-783-2874
Practice Address - Street 1:1840 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ONALASKA
Practice Address - State:WI
Practice Address - Zip Code:54650-7709
Practice Address - Country:US
Practice Address - Phone:608-783-1306
Practice Address - Fax:608-783-2874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-02
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty