Provider Demographics
NPI:1750022190
Name:DAY, COURTNEY (DMD)
Entity Type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:
Last Name:DAY
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:PO BOX 226
Mailing Address - Street 2:
Mailing Address - City:WOOTON
Mailing Address - State:KY
Mailing Address - Zip Code:41776-0226
Mailing Address - Country:US
Mailing Address - Phone:606-538-5887
Mailing Address - Fax:
Practice Address - Street 1:21154 HIGHWAY 421
Practice Address - Street 2:
Practice Address - City:HYDEN
Practice Address - State:KY
Practice Address - Zip Code:41749-8553
Practice Address - Country:US
Practice Address - Phone:606-672-1208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-06
Last Update Date:2022-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
KY107741223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program