Healthcare Provider Details

I. General information

NPI: 1083692297
Provider Name (Legal Business Name): CURTIS MARION MARSH D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48TH DENTAL SQUADRON/SGD UNIT 5210, BOX 230
APO AE
09461-0230
GB

IV. Provider business mailing address

PSC 41, BOX 5332
APO AE
09464
GB

V. Phone/Fax

Practice location:
  • Phone: 011441638528887
  • Fax:
Mailing address:
  • Phone: 011441638528887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number17740
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: