Provider Demographics
NPI:1811156953
Name:HURST, STEPHEN PATRICK SR (DDS)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:PATRICK
Last Name:HURST
Suffix:SR
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 1:218 COOPER HILL RD
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:NC
Mailing Address - Zip Code:27983-8501
Mailing Address - Country:US
Mailing Address - Phone:252-794-8671
Mailing Address - Fax:252-794-8687
Practice Address - Street 1:218 COOPER HILL RD
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:NC
Practice Address - Zip Code:27983-8501
Practice Address - Country:US
Practice Address - Phone:252-794-8671
Practice Address - Fax:252-794-8687
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-04
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4207122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist