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General NPI Number Information
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NPI Number | 1699189803
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Entity Type | Individual
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Provider Name | COURTNEY MAYOR D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/16/2014
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Last Update Date | 02/22/2019
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Provider Practice Location Address
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Address Line | 617 75TH AVE
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City | ST PETE BEACH
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State | FL
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Zip | 33706-1835
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Country | US
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Telephone | 727-367-3313
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Fax |
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Provider Business Mailing Address
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Address Line | 617 75TH AVE
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City | ST PETE BEACH
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State | FL
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Zip | 33706-1835
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 63473
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN20944
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License Number State | FL
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