Provider Demographics
NPI:1598906869
Name:MADDING, CURTIS L (GENERAL DENTISTRY)
Entity Type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:L
Last Name:MADDING
Suffix:
Gender:M
Credentials:GENERAL DENTISTRY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 220
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:CA
Mailing Address - Zip Code:93531
Mailing Address - Country:US
Mailing Address - Phone:661-823-9215
Mailing Address - Fax:661-823-9243
Practice Address - Street 1:118 SO. ROBINSON STREET
Practice Address - Street 2:
Practice Address - City:TEHACHAPI
Practice Address - State:CA
Practice Address - Zip Code:93561
Practice Address - Country:US
Practice Address - Phone:661-823-9215
Practice Address - Fax:661-823-9243
Is Sole Proprietor?:No
Enumeration Date:2009-03-17
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20115122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist