Provider Demographics
NPI:1194941393
Name:CURTIS, STEVEN BOYD (DMD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:BOYD
Last Name:CURTIS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 N 600 E
Mailing Address - Street 2:SUITE 4
Mailing Address - City:LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84341-2431
Mailing Address - Country:US
Mailing Address - Phone:435-753-1690
Mailing Address - Fax:435-752-2606
Practice Address - Street 1:1320 N 600 E
Practice Address - Street 2:SUITE 4
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84341-2431
Practice Address - Country:US
Practice Address - Phone:435-753-1690
Practice Address - Fax:435-752-2606
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1365211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT806522OtherTRICARE PROVIDER #