Provider Demographics
NPI:1518536036
Name:CURTIS, KYLE OLIVER (DMD)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:OLIVER
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 1:53 NORTH ST STE 2
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-5637
Mailing Address - Country:US
Mailing Address - Phone:203-790-0464
Mailing Address - Fax:
Practice Address - Street 1:53 NORTH ST STE 2
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-5637
Practice Address - Country:US
Practice Address - Phone:203-417-1889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-19
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2.0131551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice