Healthcare Provider Details

I. General information

NPI: 1295650125
Provider Name (Legal Business Name): ANGELA CURTIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3841 MAIN ST
ATLANTA GA
30337-3655
US

IV. Provider business mailing address

3841 MAIN ST
ATLANTA GA
30337-3655
US

V. Phone/Fax

Practice location:
  • Phone: 678-904-6775
  • Fax:
Mailing address:
  • Phone: 678-904-6775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN124343
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: