Provider Demographics
NPI:1609804244
Name:WOODFIELD, CURTIS J (DDS)
Entity Type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:J
Last Name:WOODFIELD
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 1:13910 M 40
Mailing Address - Street 2:
Mailing Address - City:GOBLES
Mailing Address - State:MI
Mailing Address - Zip Code:49055-8699
Mailing Address - Country:US
Mailing Address - Phone:269-628-2186
Mailing Address - Fax:269-628-2186
Practice Address - Street 1:13910 M 40
Practice Address - Street 2:
Practice Address - City:GOBLES
Practice Address - State:MI
Practice Address - Zip Code:49055-8699
Practice Address - Country:US
Practice Address - Phone:269-628-2186
Practice Address - Fax:269-628-2186
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI11491122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1517289Medicaid
MIJ1149103OtherBLUE CROSS