Healthcare Provider Details

I. General information

NPI: 1659446748
Provider Name (Legal Business Name): RICHARD L CURTIS DDS MS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2025 S 1300 E SUITE 1
SALT LAKE CITY UT
84105-3698
US

IV. Provider business mailing address

2025 S 1300 E SUITE 1
SALT LAKE CITY UT
84105-3698
US

V. Phone/Fax

Practice location:
  • Phone: 801-485-8192
  • Fax: 801-487-6818
Mailing address:
  • Phone: 801-485-8192
  • Fax: 801-487-6818

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number2179
License Number StateUT

VIII. Authorized Official

Name: DR. RICHARD LINDSAY CURTIS
Title or Position: OWNER
Credential: DDS MS
Phone: 801-485-8192