Provider Demographics
NPI:1447303839
Name:HURTT, TERRY ANN (DMD)
Entity type:Individual
Prefix:DR
First Name:TERRY
Middle Name:ANN
Last Name:HURTT
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:TERRY
Other - Middle Name:HURTT
Other - Last Name:DALSEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:945 LENMAR DR
Mailing Address - Street 2:
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-2000
Mailing Address - Country:US
Mailing Address - Phone:215-654-1190
Mailing Address - Fax:
Practice Address - Street 1:721 SKIPPACK PIKE
Practice Address - Street 2:#4
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-1700
Practice Address - Country:US
Practice Address - Phone:215-643-9430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS023796L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice