Walter Joseph Kucaba in Spartanburg - Periodontics
Walter Joseph Kucaba - NPI 1124083043
Walter Joseph Kucaba is a Periodontics in Spartanburg, South Carolina. Walter Joseph Kucaba practices all healthcare services and medical treatments related to Periodontics. The NPI Number for Walter Joseph Kucaba is 1124083043. The last update date is 2007-07-08.
Walter Joseph Kucaba's current location address is 151 Dillon Dr, Spartanburg, South Carolina. You can contact this provider via phone number 8645850468 and fax number 8645850469. The mailing address for Walter Joseph Kucaba is 151 Dillon Dr, Spartanburg, South Carolina. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Walter Joseph Kucaba |
|---|---|
| Address | 151 Dillon Dr, Spartanburg, South Carolina |
| Phone Number | 8645850468 |
| Fax Number | 8645850469 |
| Sole Proprietor | X |
| Credentials | DDS, MS |
NPI Number Detail
| NPI Number | 1124083043 |
|---|---|
| Provider Enumeration Date | 2006-04-20 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 151 Dillon Dr |
|---|---|
| City | Spartanburg |
| State | South Carolina (SC) |
| Post Code | 293071017 |
| Phone Number | 8645850468 |
| Fax Number | 8645850469 |
Provider's Primary Taxonomy Detail
| Speciality | Periodontics |
|---|---|
| Taxonomy | 1223P0300X |
| Licence No | 0218 PERIO |
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Definition: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structure |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 0218 PERIO | SC | SPECIALITY LICENSE |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Walter Joseph Kucaba by the Centers for Medicare & Medicaid Services?
The Walter Joseph Kucaba has been issued the NPI (National Provider Identifier) 1124083043 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you provide the complete address where Walter Joseph Kucaba is physically located?
The Walter Joseph Kucaba is situated at the following address: 151 Dillon Dr, Spartanburg, SC 293071017.
What is Walter Joseph Kucaba's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Walter Joseph Kucaba is Periodontics, and the taxonomy code that categorizes this field of expertise is 1223P0300X.
On what date was the 1124083043 assigned to Walter Joseph Kucaba?
The Walter Joseph Kucaba was issued its 1124083043 on 2006-04-20, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
When was the information regarding Walter Joseph Kucaba, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Walter Joseph Kucaba, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2007-07-08.