Healthcare Provider Details

I. General information

NPI: 1194703686
Provider Name (Legal Business Name): DOUGLAS B CURRY DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1ST MEDICAL GROUP 76 NEALY AVENUE
LANGLEY AFB VA
23665-2023
US

IV. Provider business mailing address

1ST MEDICAL GROUP 77 NEALY AVENUE
LANGLEY AFB VA
23665-2023
US

V. Phone/Fax

Practice location:
  • Phone: 757-225-7860
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number07616
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: