Provider Demographics
NPI:1619223930
Name:GARLAND, COURTNEY P (DMD)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:P
Last Name:GARLAND
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 1:600 N MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:ERWIN
Mailing Address - State:TN
Mailing Address - Zip Code:37650-1392
Mailing Address - Country:US
Mailing Address - Phone:423-743-6144
Mailing Address - Fax:423-743-6884
Practice Address - Street 1:600 N MAIN AVE
Practice Address - Street 2:
Practice Address - City:ERWIN
Practice Address - State:TN
Practice Address - Zip Code:37650-1392
Practice Address - Country:US
Practice Address - Phone:423-743-6144
Practice Address - Fax:423-743-6884
Is Sole Proprietor?:No
Enumeration Date:2012-07-24
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012022243122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist