Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223X0400X | Orthodontists | D-3557 | ID |
N | 1223X0400X | Orthodontists | D9440 | OR |
Y | 1223X0400X | Orthodontists | DE 60156965 | WA |
NPI | 1023028495 |
---|---|
Provider Name | Dr. Curtis B Bedont |
First Address | Camas, WA 98607-7415 |
Second Address | Camas, WA 98607-7415 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2006 |
Last Update Date | 28/03/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1023028495 | (05) | WA |