Provider Demographics
NPI:1407141849
Name:KUNTZ, DEBORAH K (DDS)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:K
Last Name:KUNTZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:DEBORAH
Other - Middle Name:K
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:PO BOX 60
Mailing Address - Street 2:
Mailing Address - City:SAINT CROIX FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54024-0060
Mailing Address - Country:US
Mailing Address - Phone:715-553-0333
Mailing Address - Fax:
Practice Address - Street 1:307 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:SAINT CROIX FALLS
Practice Address - State:WI
Practice Address - Zip Code:54024-9274
Practice Address - Country:US
Practice Address - Phone:715-557-4839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-14
Last Update Date:2023-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND129881223G0001X
WI6762-15122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice