Provider Demographics
NPI:1790888295
Name:CURTIS K TANABE DDS LTD
Entity type:Organization
Organization Name:CURTIS K TANABE DDS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS ADMIN
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:ZIMMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-775-4751
Mailing Address - Street 1:1197 A SOUTH COLUMBIA RD
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-4033
Mailing Address - Country:US
Mailing Address - Phone:701-775-4751
Mailing Address - Fax:701-746-4931
Practice Address - Street 1:1197 A SOUTH COLUMBIA RD
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-4033
Practice Address - Country:US
Practice Address - Phone:701-775-4751
Practice Address - Fax:701-746-4931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1557122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty