Provider Demographics
NPI:1154161867
Name:KNABEL, COURTNEY (DMD)
Entity type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:
Last Name:KNABEL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10105 LAURENT WAY UNIT 204
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40272-6325
Mailing Address - Country:US
Mailing Address - Phone:502-333-4655
Mailing Address - Fax:
Practice Address - Street 1:9901 BROWNSBORO RD STE 102
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-1100
Practice Address - Country:US
Practice Address - Phone:502-333-4655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-30
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12014438A1223G0001X
KY111511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice