Provider Demographics
NPI:1760730022
Name:PETERS, CURTIS ALLEN (DMD)
Entity Type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:ALLEN
Last Name:PETERS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1831 1ST ST
Mailing Address - Street 2:
Mailing Address - City:BAKER CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97814-3474
Mailing Address - Country:US
Mailing Address - Phone:541-523-2144
Mailing Address - Fax:541-523-3751
Practice Address - Street 1:1831 1ST ST
Practice Address - Street 2:
Practice Address - City:BAKER CITY
Practice Address - State:OR
Practice Address - Zip Code:97814-3474
Practice Address - Country:US
Practice Address - Phone:541-523-2144
Practice Address - Fax:541-523-3751
Is Sole Proprietor?:No
Enumeration Date:2012-08-16
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD9773122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist