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General NPI Number Information
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NPI Number | 1053040667
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Entity Type | Individual
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Provider Name | JONATHAN CURLIN DDS
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Gender | Male
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Dates
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Enumeration Date | 06/08/2022
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Last Update Date | 06/08/2022
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Provider Practice Location Address
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Address Line | 230 N ELMIRA AVE
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City | RUSSELLVILLE
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State | AR
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Zip | 72802-9617
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Country | US
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Telephone | 479-213-1790
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Fax |
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Provider Business Mailing Address
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Address Line | 610 HUNTER RIDGE LN APT C
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City | RUSSELLVILLE
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State | AR
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Zip | 72801-2489
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Country | US
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Telephone | 479-213-1790
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 4584
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License Number State | AR
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