Provider Demographics
NPI:1083703649
Name:CURTIS, RAYMOND J (DDS)
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:J
Last Name:CURTIS
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 1:7001 SOUTH 900 E
Mailing Address - Street 2:SUITE 350
Mailing Address - City:MIDVALE
Mailing Address - State:UT
Mailing Address - Zip Code:84047
Mailing Address - Country:US
Mailing Address - Phone:801-568-1600
Mailing Address - Fax:801-568-1879
Practice Address - Street 1:7001 SOUTH 900 E
Practice Address - Street 2:SUITE 350
Practice Address - City:MIDVALE
Practice Address - State:UT
Practice Address - Zip Code:84047
Practice Address - Country:US
Practice Address - Phone:801-568-1600
Practice Address - Fax:801-568-1879
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1363059922122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist