Provider Demographics
NPI:1609878321
Name:DELIUS, KURT E (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:KURT
Middle Name:E
Last Name:DELIUS
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10123 LAKE CREEK PKWY
Mailing Address - Street 2:BLDG 1
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78729-1755
Mailing Address - Country:US
Mailing Address - Phone:512-266-8381
Mailing Address - Fax:
Practice Address - Street 1:10123 LAKE CREEK PKWY
Practice Address - Street 2:BUILDING 1
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78729-1754
Practice Address - Country:US
Practice Address - Phone:512-335-3600
Practice Address - Fax:512-335-9771
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-12
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX166981223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics