Provider Demographics
NPI:1457498149
Name:HASELMAN, KURT S (DDS)
Entity Type:Individual
Prefix:DR
First Name:KURT
Middle Name:S
Last Name:HASELMAN
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 1:10120 ROBIOUS RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23235-4432
Mailing Address - Country:US
Mailing Address - Phone:804-272-4060
Mailing Address - Fax:804-272-8954
Practice Address - Street 1:10120 ROBIOUS RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-4432
Practice Address - Country:US
Practice Address - Phone:804-272-4060
Practice Address - Fax:804-272-8954
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014102641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice