Provider Demographics
NPI:1891874137
Name:CURTIS, TOM B (DMD)
Entity Type:Individual
Prefix:
First Name:TOM
Middle Name:B
Last Name:CURTIS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:TOM
Other - Middle Name:B
Other - Last Name:CURTIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD PC
Mailing Address - Street 1:1820 WILLAMETTE FALLS DR
Mailing Address - Street 2:
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068
Mailing Address - Country:US
Mailing Address - Phone:503-656-7340
Mailing Address - Fax:503-732-2307
Practice Address - Street 1:1820 WILLAMETTE FALLS DR
Practice Address - Street 2:
Practice Address - City:WEST LINN
Practice Address - State:OR
Practice Address - Zip Code:97068
Practice Address - Country:US
Practice Address - Phone:503-656-7340
Practice Address - Fax:503-732-2307
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD69671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice