Provider Demographics
NPI:1861450728
Name:KUNTZ, KARESSA (DDS)
Entity Type:Individual
Prefix:
First Name:KARESSA
Middle Name:
Last Name:KUNTZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 LEONARD ST STE 200
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478-2512
Mailing Address - Country:US
Mailing Address - Phone:704-502-5897
Mailing Address - Fax:
Practice Address - Street 1:66 LEONARD ST STE 2
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02478-2512
Practice Address - Country:US
Practice Address - Phone:617-484-6558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2022-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7781122300000X
PADSO83211122300000X
MADN20269122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist