Healthcare Provider Details

I. General information

NPI: 1821287988
Provider Name (Legal Business Name): CURTIS DENTAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2007
Last Update Date: 10/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1355 FLORIN RD STE 18
SACRAMENTO CA
95822-4244
US

IV. Provider business mailing address

1355 FLORIN RD STE 18
SACRAMENTO CA
95822-4244
US

V. Phone/Fax

Practice location:
  • Phone: 916-391-1161
  • Fax: 916-391-1164
Mailing address:
  • Phone: 916-391-1161
  • Fax: 916-391-1164

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number40536
License Number StateCA

VIII. Authorized Official

Name: MS. SHELLY D. COFRESI
Title or Position: OFFICE MANAGER
Credential:
Phone: 916-391-1161