Kucaba, Walter Joseph

Kucaba, Walter Joseph is an individual health care provider with primary practice located at 151 Dillon Dr , Spartanburg SC 29307-1017. He recently has only one registered license in Dental Providers / Periodontics, which is considered as his primary health care specialty. Kucaba, Walter Joseph can be contacted via phone (864) 585-0468.

Contact Information

Primary practice address
151 Dillon Dr Spartanburg SC 29307-1017
Fax: (864) 585-0469
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Periodontics 1223P0300X 0218 PERIO South Carolina

Profile Details

NPI number 1124083043
LBN Legal business name Kucaba, Walter Joseph
Credentials DDS, MS
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 20th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124083043 NPPES
South Carolina Other 0218 PERIO SPECIALITY LICENSE

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