Provider Demographics
NPI:1467552356
Name:KURTZMAN, GREGORI MICHAEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:GREGORI
Middle Name:MICHAEL
Last Name:KURTZMAN
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 1:3801 INTERNATIONAL DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-1550
Mailing Address - Country:US
Mailing Address - Phone:301-598-3500
Mailing Address - Fax:301-598-9046
Practice Address - Street 1:3801 INTERNATIONAL DR
Practice Address - Street 2:SUITE 102
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-1550
Practice Address - Country:US
Practice Address - Phone:301-598-3500
Practice Address - Fax:301-598-9046
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD92721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDMD9272OtherSTATE DENTAL LICENSE