Provider Demographics
NPI:1134301724
Name:CURTIS, CABOT (DMD)
Entity Type:Individual
Prefix:
First Name:CABOT
Middle Name:
Last Name:CURTIS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7001 S 900 E STE 350
Mailing Address - Street 2:
Mailing Address - City:MIDVALE
Mailing Address - State:UT
Mailing Address - Zip Code:84047-1750
Mailing Address - Country:US
Mailing Address - Phone:801-561-8131
Mailing Address - Fax:
Practice Address - Street 1:7001 S 900 E STE 350
Practice Address - Street 2:
Practice Address - City:MIDVALE
Practice Address - State:UT
Practice Address - Zip Code:84047-1750
Practice Address - Country:US
Practice Address - Phone:801-561-8131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-05
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2299268-99221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice