Provider Demographics
NPI:1609023894
Name:ASCHIM, KURT A (DDS)
Entity Type:Individual
Prefix:
First Name:KURT
Middle Name:A
Last Name:ASCHIM
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 1:2005 MARINETTE AVE
Mailing Address - Street 2:
Mailing Address - City:MARINETTE
Mailing Address - State:WI
Mailing Address - Zip Code:54143-3864
Mailing Address - Country:US
Mailing Address - Phone:715-732-2601
Mailing Address - Fax:715-732-2677
Practice Address - Street 1:2005 MARINETTE AVE
Practice Address - Street 2:
Practice Address - City:MARINETTE
Practice Address - State:WI
Practice Address - Zip Code:54143-3864
Practice Address - Country:US
Practice Address - Phone:715-732-2601
Practice Address - Fax:715-732-2677
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-19
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2906122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist