Provider Demographics
NPI:1568624658
Name:SMITH, COURTNEY CLEARY (DMD)
Entity Type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:CLEARY
Last Name:SMITH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:HADDONFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08033-3857
Mailing Address - Country:US
Mailing Address - Phone:215-858-0442
Mailing Address - Fax:
Practice Address - Street 1:501 N HADDON AVE STE 7
Practice Address - Street 2:
Practice Address - City:HADDONFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08033-1753
Practice Address - Country:US
Practice Address - Phone:215-858-0442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02399600122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist