Provider Demographics
NPI:1922216886
Name:CURTIS, ALBEN BENTON (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALBEN
Middle Name:BENTON
Last Name:CURTIS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:745 BRADLEY DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-2030
Mailing Address - Country:US
Mailing Address - Phone:770-461-4349
Mailing Address - Fax:770-716-8862
Practice Address - Street 1:745 BRADLEY DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-2030
Practice Address - Country:US
Practice Address - Phone:770-461-4349
Practice Address - Fax:770-716-8862
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA78541223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry