=====================================================
General NPI Number Information
=====================================================
NPI Number | 1144379124
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CURTIS D INMAN DDS PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/09/2007
-----------------------------------------------------
Last Update Date | 07/25/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 600 N 3RD STREET
-----------------------------------------------------
City | OZARK
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 65721
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 417-581-3400
-----------------------------------------------------
Fax | 417-581-3912
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | POB 333
-----------------------------------------------------
City | OZARK
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 65721
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 417-581-3400
-----------------------------------------------------
Fax | 417-581-3912
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER DENTIST
-----------------------------------------------------
Name | CURTIS D INMAN
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 417-581-3400
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | 13038
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------