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Individual
COURTNEY ETHINGTON
Active
Individual
COURTNEY ETHINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD, MSD
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2019043361
MO
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
019.032433
IL
Other
Enumeration date
12/12/2019
Last updated
12/12/2019
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