Provider Demographics
NPI:1124540141
Name:WASHNOCK, KURT (DMD)
Entity type:Individual
Prefix:DR
First Name:KURT
Middle Name:
Last Name:WASHNOCK
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 40
Mailing Address - Street 2:
Mailing Address - City:WHITNEY
Mailing Address - State:PA
Mailing Address - Zip Code:15693-0040
Mailing Address - Country:US
Mailing Address - Phone:724-972-8399
Mailing Address - Fax:
Practice Address - Street 1:1015 COURT YARD PLZ
Practice Address - Street 2:
Practice Address - City:LATROBE
Practice Address - State:PA
Practice Address - Zip Code:15650-1838
Practice Address - Country:US
Practice Address - Phone:724-539-2528
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-11
Last Update Date:2017-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0413771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice