Provider Demographics
NPI:1720114812
Name:DAILEY, CURTIS W (DDS)
Entity Type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:W
Last Name:DAILEY
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 1:2118 EXECUTIVE DR
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-2402
Mailing Address - Country:US
Mailing Address - Phone:757-826-5075
Mailing Address - Fax:578-267-3247
Practice Address - Street 1:2118 EXECUTIVE DR
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-2402
Practice Address - Country:US
Practice Address - Phone:757-826-5075
Practice Address - Fax:757-826-7324
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014101871223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA9198795Medicaid