MEDICARE: CURTIS PLATT DDS

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	122300000X	Dentist	33830	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	33830	OTHER	CA	DENTAL BOARD

General Provider Information

NPI Number	:	1881818714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CURTIS PLATT DDS

Provider Business Mailing Address
First Line	:	5247 LAMPSON AVE
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92845-1953
Country	:	US
Telephone Number	:	714-893-2453
Fax Number	:	714-893-2454

Provider Business Practice Location Address
First Line	:	5247 LAMPSON AVE
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92845-1953
Country	:	US
Telephone Number	:	714-893-2453
Fax Number	:	714-893-2454

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

Provider Enumeration Date	:	04/12/2007
Last Update Date	:	04/17/2012

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