Provider Demographics
NPI:1245578095
Name:ANSLEY, COURTNEY KIRA
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:KIRA
Last Name:ANSLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 E DAYTON YELLOW SPRINGS RD # 7790
Mailing Address - Street 2:SUITE A
Mailing Address - City:FAIRBORN
Mailing Address - State:OH
Mailing Address - Zip Code:45324-5944
Mailing Address - Country:US
Mailing Address - Phone:937-864-5022
Mailing Address - Fax:937-864-5061
Practice Address - Street 1:460 E DAYTON YELLOW SPRINGS RD # 7790
Practice Address - Street 2:SUITE A
Practice Address - City:FAIRBORN
Practice Address - State:OH
Practice Address - Zip Code:45324-5944
Practice Address - Country:US
Practice Address - Phone:937-864-5022
Practice Address - Fax:937-864-5061
Is Sole Proprietor?:No
Enumeration Date:2013-01-29
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant