Provider Demographics
NPI:1427117613
Name:MUEHLEISEN, KURT MATTHEW (DDS)
Entity type:Individual
Prefix:DR
First Name:KURT
Middle Name:MATTHEW
Last Name:MUEHLEISEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 LANDMARK DR
Mailing Address - Street 2:SUITE 124
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-4987
Mailing Address - Country:US
Mailing Address - Phone:410-768-0550
Mailing Address - Fax:410-768-8971
Practice Address - Street 1:810 LANDMARK DR
Practice Address - Street 2:SUITE 124
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-4987
Practice Address - Country:US
Practice Address - Phone:410-768-0550
Practice Address - Fax:410-768-8971
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13748122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist