Provider Demographics
NPI:1659771657
Name:DEANE, COURTNEY MEGAN (DDS)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:MEGAN
Last Name:DEANE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 6TH ST W
Mailing Address - Street 2:
Mailing Address - City:WHITEFISH
Mailing Address - State:MT
Mailing Address - Zip Code:59937-2902
Mailing Address - Country:US
Mailing Address - Phone:915-274-3310
Mailing Address - Fax:
Practice Address - Street 1:105 NUCLEUS AVE
Practice Address - Street 2:
Practice Address - City:COLUMBIA FALLS
Practice Address - State:MT
Practice Address - Zip Code:59912-4010
Practice Address - Country:US
Practice Address - Phone:406-892-2104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-26
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30115122300000X
MT17971122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist