Provider Demographics
NPI:1720196538
Name:JAMES L CURRIER DDC INC
Entity Type:Organization
Organization Name:JAMES L CURRIER DDC INC
Other - Org Name:PROVIDERS RICHARD PENMAN III EDDIE CHONG
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:JO
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-302-3535
Mailing Address - Street 1:31821 HWY 79 S
Mailing Address - Street 2:#C 7
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592
Mailing Address - Country:US
Mailing Address - Phone:951-302-3535
Mailing Address - Fax:951-302-3539
Practice Address - Street 1:31821 HWY 79 S
Practice Address - Street 2:#C 7
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592
Practice Address - Country:US
Practice Address - Phone:951-302-3535
Practice Address - Fax:951-302-3539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty