MEDICARE: DR. KYLE OLIVER CURTIS DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	2.013155	CT

General Provider Information

NPI Number	:	1518536036
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KYLE OLIVER CURTIS DMD

Provider Business Mailing Address
First Line	:	53 NORTH ST STE 2
Second Line	:
City	:	DANBURY
State	:	CT
Zip	:	06810-5637
Country	:	US
Telephone Number	:	203-790-0464
Fax Number	:

Provider Business Practice Location Address
First Line	:	53 NORTH ST STE 2
Second Line	:
City	:	DANBURY
State	:	CT
Zip	:	06810-5637
Country	:	US
Telephone Number	:	203-417-1889
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2021
Last Update Date	:	11/01/2021

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