Provider Demographics
NPI:1477698256
Name:CURETON, RUSSELL LEONARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:LEONARD
Last Name:CURETON
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 1:620 E ALVIN DR
Mailing Address - Street 2:SUITE E
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93906-3054
Mailing Address - Country:US
Mailing Address - Phone:831-449-8363
Mailing Address - Fax:831-449-8364
Practice Address - Street 1:620 E ALVIN DR
Practice Address - Street 2:SUITE E
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93906-3054
Practice Address - Country:US
Practice Address - Phone:831-449-8363
Practice Address - Fax:831-449-8364
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA314511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG92219Medicaid