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DR. DEREK TODD CORN DDS
General Practice >> Dentist >> Dental ProvidersRegistrant NPI Number: 1295220010
Individual Registrant:DR. DEREK TODD CORN DDS
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
206 S MAIN ST EDINBURGH, IN 46124-1337 US
Tel: 812-220-2676 Fax: --
Tel: 812-220-2676 Fax: --
Contact information for business:
206 S MAIN ST EDINBURGH, IN 46124-1337 US
Tel: 812-381-1525 Fax: --
Tel: 812-381-1525 Fax: --
Registration Information:
NPI: 1295220010
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 1223G0001X | Dental Providers Dentist General Practice | IN | 12012950A |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
