Provider Demographics
NPI:1295697290
Name:BADGER, CORTNEE LAUREN
Entity type:Individual
Prefix:
First Name:CORTNEE
Middle Name:LAUREN
Last Name:BADGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 FORBES ST
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-1538
Mailing Address - Country:US
Mailing Address - Phone:443-603-9000
Mailing Address - Fax:
Practice Address - Street 1:200 FORBES ST
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-1538
Practice Address - Country:US
Practice Address - Phone:443-603-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-27
Last Update Date:2025-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD8453124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist