Provider Demographics
NPI:1376769059
Name:COURTNEY, RICK BLAIR (DMD)
Entity Type:Individual
Prefix:DR
First Name:RICK
Middle Name:BLAIR
Last Name:COURTNEY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1324 OLD ESTILL SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37398-4623
Mailing Address - Country:US
Mailing Address - Phone:931-962-8010
Mailing Address - Fax:
Practice Address - Street 1:111 1ST AVE SW
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37398-1727
Practice Address - Country:US
Practice Address - Phone:931-967-2322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7055122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist