Provider Demographics
NPI:1942870514
Name:EDENS, CURTIS JAMES (DDS)
Entity Type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:JAMES
Last Name:EDENS
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 1:4804 PINTO DR
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74074-8597
Mailing Address - Country:US
Mailing Address - Phone:405-614-5531
Mailing Address - Fax:
Practice Address - Street 1:505 N 14TH ST STE B
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:OK
Practice Address - Zip Code:73077-5000
Practice Address - Country:US
Practice Address - Phone:580-336-2255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7484122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist