Provider Demographics
NPI:1942359229
Name:HURTTE, ERIC J (DMD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:J
Last Name:HURTTE
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 1:7766 WINGHAVEN BLVD
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63368-3601
Mailing Address - Country:US
Mailing Address - Phone:636-561-4117
Mailing Address - Fax:636-561-4356
Practice Address - Street 1:7766 WINGHAVEN BLVD
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368-3601
Practice Address - Country:US
Practice Address - Phone:636-561-4117
Practice Address - Fax:636-561-4356
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000161171122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist