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
Phone: (864) 585-0468
Fax: (864) 585-0469
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124083043 | NPPES |
| South Carolina | Other | 0218 PERIO | SPECIALITY LICENSE |
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