Provider Demographics
NPI:1508425786
Name:DAVID M. HURLBUT DDS PLLC
Entity Type:Organization
Organization Name:DAVID M. HURLBUT DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:HURLBUT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:315-268-8600
Mailing Address - Street 1:145 1/2 MARKET STREET
Mailing Address - Street 2:SUITE A
Mailing Address - City:POTSDAM
Mailing Address - State:NY
Mailing Address - Zip Code:13676
Mailing Address - Country:US
Mailing Address - Phone:315-268-8600
Mailing Address - Fax:315-268-8601
Practice Address - Street 1:145 1/2 MARKET STREET
Practice Address - Street 2:SUITE A
Practice Address - City:POTSDAM
Practice Address - State:NY
Practice Address - Zip Code:13676
Practice Address - Country:US
Practice Address - Phone:315-268-8600
Practice Address - Fax:315-268-8601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty