Provider Demographics
NPI:1184223844
Name:MCCOURT, CINDY (MAM)
Entity type:Individual
Prefix:MS
First Name:CINDY
Middle Name:
Last Name:MCCOURT
Suffix:
Gender:F
Credentials:MAM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8610 GREENVILLE AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-7159
Mailing Address - Country:US
Mailing Address - Phone:214-343-9280
Mailing Address - Fax:
Practice Address - Street 1:8610 GREENVILLE AVE STE 150
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-7159
Practice Address - Country:US
Practice Address - Phone:214-343-9280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-22
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX11226OtherLICENSE