Provider Demographics
NPI:1184951642
Name:TMJ & FACIAL PAIN CENTER, PA & CURTIS IMAGING CENTER
Entity type:Organization
Organization Name:TMJ & FACIAL PAIN CENTER, PA & CURTIS IMAGING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:CURTIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:214-862-4544
Mailing Address - Street 1:6407 COLLEYVILLE BLVD
Mailing Address - Street 2:#A
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034
Mailing Address - Country:US
Mailing Address - Phone:817-442-1200
Mailing Address - Fax:817-442-1217
Practice Address - Street 1:6407 COLLEYVILLE BLVD
Practice Address - Street 2:STE. A
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76084
Practice Address - Country:US
Practice Address - Phone:817-442-1200
Practice Address - Fax:817-442-1217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-04
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14174122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX50056921OtherDDS #
TXAC2788341OtherDEA #