Provider Demographics
NPI:1306399753
Name:HAIN, COURTNEY M (DDS)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:M
Last Name:HAIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:RACHELLE
Other - Last Name:MASON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:450 SUTTER ST RM 1422
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108-4003
Mailing Address - Country:US
Mailing Address - Phone:415-237-3456
Mailing Address - Fax:
Practice Address - Street 1:450 SUTTER ST RM 1422
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-4003
Practice Address - Country:US
Practice Address - Phone:415-237-3456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-02
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100611122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist