Provider Demographics
NPI:1639167422
Name:CURLEY, LATRICIA E (DENTIST)
Entity Type:Individual
Prefix:DR
First Name:LATRICIA
Middle Name:E
Last Name:CURLEY
Suffix:
Gender:F
Credentials:DENTIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 UNIVERSITY BLVD
Mailing Address - Street 2:SUITE B9-517
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35401-0327
Mailing Address - Country:US
Mailing Address - Phone:214-232-7562
Mailing Address - Fax:
Practice Address - Street 1:1911 SKYLAND BLVD E
Practice Address - Street 2:SUITE A-3
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35405-1541
Practice Address - Country:US
Practice Address - Phone:205-469-0444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX215201223G0001X
AL61171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX171598901Medicaid