Provider Demographics
NPI:1801167663
Name:WEDEL, COURTNEY ANN (DDS)
Entity type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:ANN
Last Name:WEDEL
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 1:500 N. FINANCIAL CENTER TERRACE
Mailing Address - Street 2:
Mailing Address - City:MUSTANG
Mailing Address - State:OK
Mailing Address - Zip Code:73064-0000
Mailing Address - Country:US
Mailing Address - Phone:405-376-2072
Mailing Address - Fax:
Practice Address - Street 1:500 N FINANCIAL TER STE D
Practice Address - Street 2:
Practice Address - City:MUSTANG
Practice Address - State:OK
Practice Address - Zip Code:73064-4432
Practice Address - Country:US
Practice Address - Phone:405-376-2072
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-25
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6307122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist