Provider Demographics
NPI:1720473598
Name:CURTIS, KIMBERLY AGBULOS (DDS)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:AGBULOS
Last Name:CURTIS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3212 BROOKVIEW PL
Mailing Address - Street 2:
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-2807
Mailing Address - Country:US
Mailing Address - Phone:732-642-0026
Mailing Address - Fax:
Practice Address - Street 1:515 STUMP RD
Practice Address - Street 2:
Practice Address - City:NORTH WALES
Practice Address - State:PA
Practice Address - Zip Code:19454
Practice Address - Country:US
Practice Address - Phone:215-874-0888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-30
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI025933001223G0001X
PADS0416371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice