Individual
DR. KOURT BEAU CHATELAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
805 TURTLE CREEK DR, TYLER, TX 75701-1937
(903) 592-1664
(903) 525-1099
Mailing address
805 TURTLE CREEK DR, TYLER, TX 75701-1937
(903) 592-1664
(903) 525-1099
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
28677
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28677
TEXAS DENTAL LICENSE
TX
05
—
32475102
—
TX
Enumeration date
04/14/2009
Last updated
01/23/2023
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