MEDICARE: DR. LATRICIA E CURLEY DENTIST

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	21520	TX
2	1223G0001X	General Practice Dentistry	6117	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639167422
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LATRICIA E CURLEY DENTIST

Provider Business Mailing Address
First Line	:	1130 UNIVERSITY BLVD
Second Line	:	SUITE B9-517
City	:	TUSCALOOSA
State	:	AL
Zip	:	35401-0327
Country	:	US
Telephone Number	:	214-232-7562
Fax Number	:

Provider Business Practice Location Address
First Line	:	1911 SKYLAND BLVD E
Second Line	:	SUITE A-3
City	:	TUSCALOOSA
State	:	AL
Zip	:	35405-1541
Country	:	US
Telephone Number	:	205-469-0444
Fax Number	:

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

Provider Enumeration Date	:	10/06/2005
Last Update Date	:	04/12/2017

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Directions to “ DR. LATRICIA E CURLEY DENTIST” Practice Location

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