Individual
COURTNEY T MIETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD MS
Contact information
Practice address
2295 FIELDSTONE DR STE 260, LINCOLN, CA 95648-8810
(916) 408-8688
Mailing address
2295 FIELDSTONE DR STE 260, LINCOLN, CA 95648-8810
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
112725
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
2025004576
MO
Other
Enumeration date
04/08/2025
Last updated
03/03/2026
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