Provider Demographics
NPI:1033933528
Name:MARTEN, COURTNEY MARIE (RDH, OMT)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:MARIE
Last Name:MARTEN
Suffix:
Gender:F
Credentials:RDH, OMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:831 CRITTER CT STE 200
Mailing Address - Street 2:
Mailing Address - City:ONALASKA
Mailing Address - State:WI
Mailing Address - Zip Code:54650-8672
Mailing Address - Country:US
Mailing Address - Phone:608-394-3943
Mailing Address - Fax:
Practice Address - Street 1:831 CRITTER CT STE 200
Practice Address - Street 2:
Practice Address - City:ONALASKA
Practice Address - State:WI
Practice Address - Zip Code:54650-8672
Practice Address - Country:US
Practice Address - Phone:608-394-3943
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-11
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1003260-16124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist