Individual
CASEY RENEA CORNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.H.
Contact information
Practice address
550 6TH AVE N, WOLF POINT, MT 59201-6000
(406) 653-1461
(406) 653-3728
Mailing address
550 6TH AVE N, WOLF POINT, MT 59201-6000
(406) 653-1461
(406) 653-3728
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
4084
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2210068
—
MT
01
—
4084
KY BOARD OF DENTISTRY
KY
Enumeration date
11/15/2010
Last updated
06/19/2019
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