Provider Demographics
NPI:1194818377
Name:KURT A. ASCHIM, DDS,SC
Entity type:Organization
Organization Name:KURT A. ASCHIM, DDS,SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KURT
Authorized Official - Middle Name:
Authorized Official - Last Name:ASCHIM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:715-732-2601
Mailing Address - Street 1:2005 MARINETTE AVE
Mailing Address - Street 2:
Mailing Address - City:MARINETTE
Mailing Address - State:WI
Mailing Address - Zip Code:54143-3864
Mailing Address - Country:US
Mailing Address - Phone:715-732-2601
Mailing Address - Fax:715-732-2677
Practice Address - Street 1:2005 MARINETTE AVE
Practice Address - Street 2:
Practice Address - City:MARINETTE
Practice Address - State:WI
Practice Address - Zip Code:54143-3864
Practice Address - Country:US
Practice Address - Phone:715-732-2601
Practice Address - Fax:715-732-2677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI29061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty