Provider Demographics
NPI:1831178896
Name:FLECKENSTEIN, KURT BAKER (DDS)
Entity type:Individual
Prefix:DR
First Name:KURT
Middle Name:BAKER
Last Name:FLECKENSTEIN
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 1:2 BAYBERRY DR
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NH
Mailing Address - Zip Code:03031-2515
Mailing Address - Country:US
Mailing Address - Phone:910-977-3409
Mailing Address - Fax:
Practice Address - Street 1:2674 5TH AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25702-1329
Practice Address - Country:US
Practice Address - Phone:304-525-2630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV33421223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
BF7069760OtherFEDERAL DEA