Provider Demographics
NPI:1790248904
Name:HUSSEY, KURTIS PAUL (DMD)
Entity Type:Individual
Prefix:DR
First Name:KURTIS
Middle Name:PAUL
Last Name:HUSSEY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 E VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34134-7432
Mailing Address - Country:US
Mailing Address - Phone:239-682-2149
Mailing Address - Fax:
Practice Address - Street 1:1001 10TH AVE S
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-8237
Practice Address - Country:US
Practice Address - Phone:239-566-2255
Practice Address - Fax:239-566-1788
Is Sole Proprietor?:No
Enumeration Date:2019-04-13
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN23809122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist