Provider Demographics
NPI:1265423602
Name:KURZROCK, MATTHIAS DAVID (DDS)
Entity type:Individual
Prefix:DR
First Name:MATTHIAS
Middle Name:DAVID
Last Name:KURZROCK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2673 CASSANDRA CT
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-4459
Mailing Address - Country:US
Mailing Address - Phone:925-465-4611
Mailing Address - Fax:925-465-4611
Practice Address - Street 1:2673 CASSANDRA CT
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-4459
Practice Address - Country:US
Practice Address - Phone:925-465-4611
Practice Address - Fax:925-465-4611
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18362122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist