Individual
COURTNEY ANN DIERKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
530 S MAIDEN LN, JOPLIN, MO 64801-3084
(417) 782-6200
Mailing address
1213B MONTANA PL, JOPLIN, MO 64804-2342
(314) 899-7823
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2018043179
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AMS202200
ASPEN STM
—
Enumeration date
10/08/2020
Last updated
11/27/2023
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