Provider Demographics
NPI:1962596999
Name:HADLEY, CURTIS LYNN (DDS)
Entity type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:LYNN
Last Name:HADLEY
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 1:971 W 1700 S
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:UT
Mailing Address - Zip Code:84075-9127
Mailing Address - Country:US
Mailing Address - Phone:801-774-8967
Mailing Address - Fax:801-774-8050
Practice Address - Street 1:971 W 1700 S
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:UT
Practice Address - Zip Code:84075-9127
Practice Address - Country:US
Practice Address - Phone:801-774-8967
Practice Address - Fax:801-774-8050
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT3415981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT961931OtherUNITED CONCORDIA PROVIDER