Healthcare Provider Details

I. General information

NPI: 1851303028
Provider Name (Legal Business Name): STEPHEN A. CURTIS D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 MONTAUK HWY SUITE 2
EAST MORICHES NY
11940-1225
US

IV. Provider business mailing address

516 MONTAUK HWY SUITE 2
EAST MORICHES NY
11940-1225
US

V. Phone/Fax

Practice location:
  • Phone: 631-874-4747
  • Fax:
Mailing address:
  • Phone: 631-874-4747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number36830
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: