Provider Demographics
NPI:1891856639
Name:BRIMLEY, CURTIS (DMD, MS)
Entity Type:Individual
Prefix:
First Name:CURTIS
Middle Name:
Last Name:BRIMLEY
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1388 SKYSCAPE WAY
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-2255
Mailing Address - Country:US
Mailing Address - Phone:801-664-8895
Mailing Address - Fax:
Practice Address - Street 1:1388 SKYSCAPE WAY
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-2255
Practice Address - Country:US
Practice Address - Phone:801-664-8895
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT380340-99221223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics