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General NPI Number Information
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NPI Number | 1205328085
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Entity Type | Individual
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Provider Name | CURTIS A THIBEAULT DMD
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Gender | Male
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Dates
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Enumeration Date | 06/06/2018
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Last Update Date | 09/02/2020
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Provider Practice Location Address
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Address Line | 291 MAIN STREET
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City | ALTON
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State | NH
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Zip | 03809
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Country | US
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Telephone | 603-855-2017
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Fax |
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Provider Business Mailing Address
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Address Line | 40 WINTER ST STE 201
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City | ROCHESTER
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State | NH
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Zip | 03867-3139
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Country | US
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Telephone | 603-332-7300
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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 | 04412
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License Number State | NH
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