Provider Demographics
NPI:1376636399
Name:CALENDER, KURT MARSHALL (DMD)
Entity Type:Individual
Prefix:DR
First Name:KURT
Middle Name:MARSHALL
Last Name:CALENDER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 W SOUTHLAKE BLVD
Mailing Address - Street 2:SUITE #115
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-6748
Mailing Address - Country:US
Mailing Address - Phone:817-442-8282
Mailing Address - Fax:817-442-8211
Practice Address - Street 1:2001 W SOUTHLAKE BLVD
Practice Address - Street 2:SUITE #115
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-6748
Practice Address - Country:US
Practice Address - Phone:817-442-8282
Practice Address - Fax:817-442-8211
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX147321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice