MEDICARE: DR. THOMAS JOSEPH CURTIN D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	AC8968022	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00467	OTHER	MA	DELTA DENTAL INSURANCE
2	00467	OTHER	MA	ALTUS DENTAL INSURANCE
3	X04445	OTHER	MA	BC/BS DENTAL INSURANCE

General Provider Information

NPI Number	:	1104821214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS JOSEPH CURTIN D.D.S.

Provider Business Mailing Address
First Line	:	747 W MAIN ST
Second Line	:
City	:	AVON
State	:	MA
Zip	:	02322-1746
Country	:	US
Telephone Number	:	508-587-8300
Fax Number	:	508-583-9449

Provider Business Practice Location Address
First Line	:	747 W MAIN ST
Second Line	:
City	:	AVON
State	:	MA
Zip	:	02322-1746
Country	:	US
Telephone Number	:	508-587-8300
Fax Number	:	508-583-9449

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	07/08/2007

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