Provider Demographics
NPI:1497813836
Name:DEWEY, BRIAN CURTIS (DDS)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:CURTIS
Last Name:DEWEY
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 1:6000 SOUTH DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33405
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6000 SOUTH DIXIE HWY
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33405
Practice Address - Country:US
Practice Address - Phone:561-582-7660
Practice Address - Fax:561-588-7316
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN100221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL075076000Medicaid
FL59-1347715OtherFEDERAL TAX I D