Individual
DR. KOURT BEAU CHATELAIN
Active
Individual
DR. KOURT BEAU CHATELAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
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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