Provider Demographics
NPI:1437188265
Name:AVCIKURT, UGUR F (DMD)
Entity Type:Individual
Prefix:DR
First Name:UGUR
Middle Name:F
Last Name:AVCIKURT
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 1:161 LAKE SHORE RD
Mailing Address - Street 2:#1
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-6345
Mailing Address - Country:US
Mailing Address - Phone:617-782-1171
Mailing Address - Fax:
Practice Address - Street 1:10 KIRTLAND ST
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01905-1821
Practice Address - Country:US
Practice Address - Phone:781-595-2552
Practice Address - Fax:781-533-0730
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA188911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0279366Medicaid