Provider Demographics
NPI:1225288988
Name:VONGUNTEN, CURTIS (DMD)
Entity Type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:
Last Name:VONGUNTEN
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 1:5622 NW 43RD ST
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32653-3332
Mailing Address - Country:US
Mailing Address - Phone:352-378-3139
Mailing Address - Fax:352-371-0135
Practice Address - Street 1:5622 NW 43RD ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32653-3332
Practice Address - Country:US
Practice Address - Phone:352-378-3139
Practice Address - Fax:352-371-0135
Is Sole Proprietor?:No
Enumeration Date:2008-09-30
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN18450122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist