Provider Demographics
NPI:1255124053
Name:CURTIS WEST DMD PLLC
Entity type:Organization
Organization Name:CURTIS WEST DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:IVAN
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:832-928-1937
Mailing Address - Street 1:19040 N 73RD DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-5809
Mailing Address - Country:US
Mailing Address - Phone:832-928-1937
Mailing Address - Fax:
Practice Address - Street 1:25355 N LAKE PLEASANT PKWY UNIT 103
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85383-1504
Practice Address - Country:US
Practice Address - Phone:623-937-1888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-24
Last Update Date:2025-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental