Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 3915 | FL |
NPI | 1003023524 |
---|---|
Provider Name | Dr. L E Curenton |
First Address | Crestview, FL 32536-2708 |
Second Address | Crestview, FL 32536-2751 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2007 |
Last Update Date | 08/07/2007 |