Provider Demographics
NPI:1366445777
Name:LECIEJEWSKI, CURTIS JAMES (DDS)
Entity Type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:JAMES
Last Name:LECIEJEWSKI
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 1:19643 BLUE BIRD LN
Mailing Address - Street 2:STE 1
Mailing Address - City:REHOBOTH BEACH
Mailing Address - State:DE
Mailing Address - Zip Code:19971-6129
Mailing Address - Country:US
Mailing Address - Phone:302-226-7960
Mailing Address - Fax:302-226-7963
Practice Address - Street 1:19643 BLUE BIRD LN
Practice Address - Street 2:STE 1
Practice Address - City:REHOBOTH BEACH
Practice Address - State:DE
Practice Address - Zip Code:19971-6129
Practice Address - Country:US
Practice Address - Phone:302-226-7960
Practice Address - Fax:302-226-7963
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-31
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEG1-0001118122300000X
MD9885122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist