Doctor Name: | MR. STEVEN G CORBETT |
NPI Number: | 1366574378 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LD |
License Number: | DT-DO-643631 |
Business Practice Address: | 300 Nw 3rd Ave Canby, OR - 970133603 |
Business Phone Number: | 5032661800 |
Business Fax Number: | |
Mailing Address: | 6799 Sw Alden St, PORTLAND |
State: | OR |
Postal Code: | 972231328 |
Phone Number: | 5032447355 |
Fax Number: | |
NPI Enumeration Date: | 03/12/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 122400000X |
License Number: | DT-DO-643631 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Dental Providers |
Taxonomy Classification: | Denturist |
Taxonomy Specialization: | |
Taxonomy Definition: |