Individual
DANIELLE MCCOURT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1775 LOCUST ST, SAN DIEGO, CA 92106-1904
(623) 293-1529
Mailing address
1775 LOCUST ST, SAN DIEGO, CA 92106-1904
(623) 293-1529
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
100812
CA
1223G0001X
General Practice Dentistry
100812
CA
Other
Enumeration date
09/04/2016
Last updated
05/03/2024
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