Provider Demographics
NPI:1134600448
Name:CURTIS R. HEBDON, D.D.S., S.C.
Entity type:Organization
Organization Name:CURTIS R. HEBDON, D.D.S., S.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:R
Authorized Official - Last Name:HEBDON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:920-766-9542
Mailing Address - Street 1:233 DODGE ST
Mailing Address - Street 2:
Mailing Address - City:KAUKAUNA
Mailing Address - State:WI
Mailing Address - Zip Code:54130-2500
Mailing Address - Country:US
Mailing Address - Phone:920-766-9542
Mailing Address - Fax:
Practice Address - Street 1:233 DODGE ST
Practice Address - Street 2:
Practice Address - City:KAUKAUNA
Practice Address - State:WI
Practice Address - Zip Code:54130-2500
Practice Address - Country:US
Practice Address - Phone:920-766-9542
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-24
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1001802-15261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental