Provider Demographics
NPI:1770789018
Name:KURTZ, JEFFREY A (DDS)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:A
Last Name:KURTZ
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 1:5164 HIGHLAND MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-9074
Mailing Address - Country:US
Mailing Address - Phone:614-777-6355
Mailing Address - Fax:
Practice Address - Street 1:1709 BRICE RD
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-2703
Practice Address - Country:US
Practice Address - Phone:614-522-0024
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-01-35201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice