Chatelain, Kourt Beau
Chatelain, Kourt Beau is an individual health care provider with primary practice located at 805 Turtle Creek Dr , Tyler TX 75701-1937. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Chatelain, Kourt Beau can be contacted via phone (903) 592-1664.Contact Information
Primary practice address
805 Turtle Creek Dr
Tyler TX 75701-1937
Phone: (903) 592-1664
Fax: (903) 525-1099
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 28677 | Texas |
Profile Details
| NPI number | 1366685810 |
|---|---|
| LBN Legal business name | Chatelain, Kourt Beau |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 14th, 2009 |
| Last updated | Jan 23rd, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366685810 | NPPES |
| Texas | Other | 28677 | TEXAS DENTAL LICENSE |
| Texas | MEDICAID | 32475102 | TEXAS DENTAL LICENSE |
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