Provider Demographics
NPI:1508869595
Name:COURTNEY, MARTIN C (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:C
Last Name:COURTNEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18911 NORDHOFF STREET
Mailing Address - Street 2:SUITE #38
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324
Mailing Address - Country:US
Mailing Address - Phone:818-886-6696
Mailing Address - Fax:818-886-2502
Practice Address - Street 1:18911 NORDHOFF STREET
Practice Address - Street 2:SUITE #38
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324
Practice Address - Country:US
Practice Address - Phone:818-886-6696
Practice Address - Fax:818-886-2502
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-23
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA312361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice