Individual
KURTIS GREGORY HAUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
520 N 12TH ST # 222, RICHMOND, VA 23298-5064
(804) 828-0843
Mailing address
1401 KERR DR, RICHMOND, VA 23227-2264
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
0442000496
VA
Other
Enumeration date
06/08/2023
Last updated
06/08/2023
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