Individual provider · Type 1 NPI

Courtney Clough, RDH AND OMT

Specialist · Wichita, KS

NPI number 1265388664 Active

Practice location

2548 N Maize Ct Ste 110
Wichita, KS 67205-7348

Call (316) 394-0814 Map

Mailing address

2620 E Mantane St, 2620 E. Mantane St
Wichita, KS 67219-3063

Specialties and licenses

TaxonomyCodeLicense
Dental Hygienist 124Q00000X10848 (KS)
Specialist Primary 174400000XNone listed

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1265388664

Courtney Clough, RDH AND OMT's National Provider Identifier is 1265388664, issued on Mar 9, 2026. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Wichita, KS. The record was last updated on Mar 9, 2026.