Provider Demographics
NPI:1033397757
Name:HO, COURTNEY L (DDS)
Entity Type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:L
Last Name:HO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:COURTNEY
Other - Middle Name:L
Other - Last Name:LESACA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:LANDSTUHL DENTAL ACTIVITY CREDENTIALS OFFICE
Mailing Address - Street 2:CMR 402
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09180
Mailing Address - Country:US
Mailing Address - Phone:01149637-192-9130
Mailing Address - Fax:01149637-192-9117
Practice Address - Street 1:LANDSTUHL DENTAL ACTIVITY CREDENTIALS OFFICE
Practice Address - Street 2:CMR 402
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09180
Practice Address - Country:US
Practice Address - Phone:01149637-192-9130
Practice Address - Fax:01149637-192-9117
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-05
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23388122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist