Provider Demographics
NPI:1083749030
Name:HIGHSMITH, COURTNEY CAMP (DMD)
Entity Type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:CAMP
Last Name:HIGHSMITH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:MS
Other - First Name:COURTNEY
Other - Middle Name:LEIGH
Other - Last Name:CAMP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:3666 HIGHWAY 5 STE 102
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-6940
Mailing Address - Country:US
Mailing Address - Phone:770-942-2852
Mailing Address - Fax:770-942-3502
Practice Address - Street 1:3666 HIGHWAY 5 STE 102
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-6940
Practice Address - Country:US
Practice Address - Phone:770-942-2852
Practice Address - Fax:770-942-3502
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0128291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice