Provider Demographics
NPI:1376775726
Name:COURTRIGHT, MICHAEL J (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:COURTRIGHT
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2230 S AUSTIN AVE
Mailing Address - Street 2:
Mailing Address - City:DENISON
Mailing Address - State:TX
Mailing Address - Zip Code:75020-7724
Mailing Address - Country:US
Mailing Address - Phone:903-463-6013
Mailing Address - Fax:
Practice Address - Street 1:2230 S AUSTIN AVE
Practice Address - Street 2:
Practice Address - City:DENISON
Practice Address - State:TX
Practice Address - Zip Code:75020
Practice Address - Country:US
Practice Address - Phone:903-463-6013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-19
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1861223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics