Individual
COURTNEY BUMBAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
510 N MAIN ST, COLUMBIA CITY, IN 46725-1314
(260) 212-5058
(260) 232-0053
Mailing address
1202 S 500 E, COLUMBIA CITY, IN 46725-9049
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12012735A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
46725
ZIP
—
Enumeration date
06/26/2017
Last updated
01/06/2020
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