Provider Demographics
NPI:1427675677
Name:KUYK, CORY S (DMD)
Entity type:Individual
Prefix:DR
First Name:CORY
Middle Name:S
Last Name:KUYK
Suffix:
Gender:F
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 2045
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24212-2045
Mailing Address - Country:US
Mailing Address - Phone:276-628-9507
Mailing Address - Fax:276-628-9439
Practice Address - Street 1:1415 PATTON AVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-1721
Practice Address - Country:US
Practice Address - Phone:828-254-9692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-02
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401416977122300000X
NC12209122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist