Provider Demographics
NPI:1063756153
Name:STEVEN L. CURETON, DMD, MS
Entity type:Organization
Organization Name:STEVEN L. CURETON, DMD, MS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:
Authorized Official - Last Name:CURETON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-246-7121
Mailing Address - Street 1:2753 E CENTER ST
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37664-2715
Mailing Address - Country:US
Mailing Address - Phone:423-246-7121
Mailing Address - Fax:423-246-8510
Practice Address - Street 1:2753 E CENTER ST
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37664-2715
Practice Address - Country:US
Practice Address - Phone:423-246-7121
Practice Address - Fax:423-246-8510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7607261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
1417204652OtherNPI TYPE 1
1619042934OtherNPI TYPE 1
TN3206005Medicaid