Provider Demographics
NPI:1295142677
Name:CURTIS, PAUL DANIEL (DMD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:DANIEL
Last Name:CURTIS
Suffix:
Gender:
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3575 E MARDIA ST
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-5481
Mailing Address - Country:US
Mailing Address - Phone:801-631-3934
Mailing Address - Fax:
Practice Address - Street 1:3289 N TOWERBRIDGE WAY
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83646-8347
Practice Address - Country:US
Practice Address - Phone:208-884-4466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-17
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD-52311223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics