Healthcare Provider Details

I. General information

NPI: 1295142677
Provider Name (Legal Business Name): PAUL DANIEL CURTIS DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2014
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3289 N TOWERBRIDGE WAY
MERIDIAN ID
83646-8347
US

IV. Provider business mailing address

3575 E MARDIA ST
MERIDIAN ID
83642-5481
US

V. Phone/Fax

Practice location:
  • Phone: 208-884-4466
  • Fax:
Mailing address:
  • Phone: 801-631-3934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberD-5231
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: