Provider Demographics
NPI:1538223052
Name:CURTIS, DAVID K (DMD, PA)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:K
Last Name:CURTIS
Suffix:
Gender:M
Credentials:DMD, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39705-1935
Mailing Address - Country:US
Mailing Address - Phone:662-327-0995
Mailing Address - Fax:662-327-0996
Practice Address - Street 1:300 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39705-1935
Practice Address - Country:US
Practice Address - Phone:662-327-0995
Practice Address - Fax:662-327-0996
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2264-861223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00060291Medicaid
MS710936864OtherEIN