Provider Demographics
NPI:1558448043
Name:CURETON, JEROME CLAYTON (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEROME
Middle Name:CLAYTON
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 1:9148 ANCHOR MARK DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46236-9346
Mailing Address - Country:US
Mailing Address - Phone:317-826-0654
Mailing Address - Fax:317-259-7321
Practice Address - Street 1:6132 ALLISONVILLE RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-4608
Practice Address - Country:US
Practice Address - Phone:317-259-7310
Practice Address - Fax:317-259-7321
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN120097131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
INBC4270613Medicaid