Organization
KURT A. MCKISSICK, DDS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KURT A. MCKISSICK DDS (PRESIDENT)
(919) 481-3007
Entity
Organization
Contact information
Practice address
107 EDINBURGH SOUTH DR STE 200, CARY, NC 27511-6454
(919) 481-3007
(919) 481-6637
Mailing address
107 EDINBURGH SOUTH DR STE 200, CARY, NC 27511-6454
(919) 481-3007
(919) 481-6637
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4668
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4668
LICENSE #
NC
Enumeration date
05/08/2007
Last updated
08/22/2020
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