Provider Demographics
NPI:1588673685
Name:COURTER, MICHAEL CLAY (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:CLAY
Last Name:COURTER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4305 N GARFIELD ST
Mailing Address - Street 2:SUITE 221
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79705-4338
Mailing Address - Country:US
Mailing Address - Phone:432-682-0786
Mailing Address - Fax:
Practice Address - Street 1:4305 N GARFIELD ST
Practice Address - Street 2:SUITE 221
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79705-4338
Practice Address - Country:US
Practice Address - Phone:432-682-0786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX119921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice