Provider Demographics
NPI:1659596690
Name:DILL, CURTIS
Entity Type:Individual
Prefix:
First Name:CURTIS
Middle Name:
Last Name:DILL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1704 MILITARY PKWY
Mailing Address - Street 2:STE 700
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-3673
Mailing Address - Country:US
Mailing Address - Phone:972-288-7272
Mailing Address - Fax:972-288-5364
Practice Address - Street 1:1704 MILITARY PKWY
Practice Address - Street 2:STE 700
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-3673
Practice Address - Country:US
Practice Address - Phone:972-288-7272
Practice Address - Fax:972-288-5364
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX141771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice