Provider Demographics
NPI:1336718857
Name:CURTIS LLC
Entity Type:Organization
Organization Name:CURTIS LLC
Other - Org Name:NORTHSTAR DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:OLIVER
Authorized Official - Last Name:CURTIS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:203-417-1889
Mailing Address - Street 1:53 NORTH ST STE 2
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-5637
Mailing Address - Country:US
Mailing Address - Phone:203-743-6083
Mailing Address - Fax:
Practice Address - Street 1:12 CHAPEL PL
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-6699
Practice Address - Country:US
Practice Address - Phone:203-417-1889
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-19
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental