Provider Demographics
NPI:1013667310
Name:BEN D CURTIS, DDS, PLLC
Entity Type:Organization
Organization Name:BEN D CURTIS, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CURTIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-754-0828
Mailing Address - Street 1:36420 STATE HIGHWAY 64
Mailing Address - Street 2:
Mailing Address - City:WILLS POINT
Mailing Address - State:TX
Mailing Address - Zip Code:75169-7406
Mailing Address - Country:US
Mailing Address - Phone:972-754-0828
Mailing Address - Fax:
Practice Address - Street 1:17260 I-20 FRONTAGE RD.
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:TX
Practice Address - Zip Code:75103
Practice Address - Country:US
Practice Address - Phone:430-340-5015
Practice Address - Fax:430-340-5025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-28
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX347900805Medicaid