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General NPI Number Information
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NPI Number | 1922612449
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Entity Type | Individual
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Provider Name | CURTIS EUGENE DOSSMCDANIEL III REGISTERED DENTAL AS
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Gender | Male
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Dates
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Enumeration Date | 09/02/2020
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Last Update Date | 09/02/2020
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Provider Practice Location Address
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Address Line | 3027 W FLORDIA AVE
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City | HEMET
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State | CA
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Zip | 92545
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Country | US
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Telephone | 951-330-4618
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Fax |
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Provider Business Mailing Address
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Address Line | 3027 W FLORIDA AVE
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City | HEMET
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State | CA
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Zip | 92545-3617
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Country | US
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Telephone | 951-330-4618
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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 | 126800000X
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Taxonomy Name | Dental Assistant
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License Number | 94098
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License Number State | CA
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