Provider Demographics
NPI:1679571632
Name:KURACINA, ELAINE M (DMD)
Entity Type:Individual
Prefix:DR
First Name:ELAINE
Middle Name:M
Last Name:KURACINA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 PIERREPONT AVE
Mailing Address - Street 2:
Mailing Address - City:POTSDAM
Mailing Address - State:NY
Mailing Address - Zip Code:13676-2107
Mailing Address - Country:US
Mailing Address - Phone:315-268-9517
Mailing Address - Fax:
Practice Address - Street 1:29 PIERREPONT AVE
Practice Address - Street 2:
Practice Address - City:POTSDAM
Practice Address - State:NY
Practice Address - Zip Code:13676-2107
Practice Address - Country:US
Practice Address - Phone:315-268-9517
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032003122300000X
CA29334122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist