Provider Demographics
NPI:1215238373
Name:CURTIS, CARRIE JO (RDH)
Entity type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:JO
Last Name:CURTIS
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 BALD MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04429-4110
Mailing Address - Country:US
Mailing Address - Phone:207-415-2187
Mailing Address - Fax:
Practice Address - Street 1:70 KINGSLAND XING STE A
Practice Address - Street 2:
Practice Address - City:ELLSWORTH
Practice Address - State:ME
Practice Address - Zip Code:04605-2570
Practice Address - Country:US
Practice Address - Phone:207-667-6789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-05
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERDH2785124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist