Provider Demographics
NPI:1124148788
Name:WADE, CURTIS K (DDS)
Entity type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:K
Last Name:WADE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 W FAIRHAVEN AVE
Mailing Address - Street 2:STE C
Mailing Address - City:BURLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98233-1062
Mailing Address - Country:US
Mailing Address - Phone:360-757-0201
Mailing Address - Fax:360-757-1990
Practice Address - Street 1:205 W FAIRHAVEN AVE
Practice Address - Street 2:STE C
Practice Address - City:BURLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98233-1062
Practice Address - Country:US
Practice Address - Phone:360-757-0201
Practice Address - Fax:360-757-1990
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA51081223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics