Provider Demographics
NPI:1831265271
Name:CURTIS, JAMES WINTON JR (DMD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:WINTON
Last Name:CURTIS
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 743904
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3904
Mailing Address - Country:US
Mailing Address - Phone:803-296-7320
Mailing Address - Fax:803-296-7330
Practice Address - Street 1:10 RICHLAND MEDICAL PARK DR STE A
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6892
Practice Address - Country:US
Practice Address - Phone:803-434-6565
Practice Address - Fax:803-434-6299
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2018-10-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC21691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC399504Medicaid
SCU94761Medicare UPIN