| Doctor Name: | LINDSAY ELIZABETH CORBETT-REISER |
| NPI Number: | 1194148783 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | L.D. |
| License Number: | DT-DO-10149646 |
| Business Practice Address: | 300 Nw 3rd Ave Canby, OR - 970133603 |
| Business Phone Number: | 5032661800 |
| Business Fax Number: | 5032661800 |
| Mailing Address: | 300 Nw 3rd Ave, CANBY |
| State: | OR |
| Postal Code: | 970133603 |
| Phone Number: | 5032661800 |
| Fax Number: | 5032661800 |
| NPI Enumeration Date: | 02/03/2014 |
| NPI Last Update Date: | 02/03/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 122400000X |
| License Number: | DT-DO-10149646 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Dental Providers |
| Taxonomy Classification: | Denturist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |