Provider Demographics
NPI:1821156019
Name:CURTIS, BRENT E (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRENT
Middle Name:E
Last Name:CURTIS
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 1:2025 SOUTH 1300 EAST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84105
Mailing Address - Country:US
Mailing Address - Phone:801-487-7991
Mailing Address - Fax:801-487-6818
Practice Address - Street 1:2025 SOUTH 1300 EAST
Practice Address - Street 2:SUITE 3
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84105
Practice Address - Country:US
Practice Address - Phone:801-487-7991
Practice Address - Fax:801-487-6818
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1447851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice