Individual provider · NPI-1

Corbin Avey

Dentist, General Practice · Medford, OR

NPI number1568075554
StatusActive
Last updated in NPPESNov 8, 2023

Details

NPI
1568075554
Entity type
Individual (NPI-1)
Name
Corbin Avey
Sex
Male
Sole proprietor
No
Enumeration date
Aug 28, 2020
Certification date
Nov 8, 2023
Last updated
Nov 8, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General PracticeD11314ORYes
122300000X DentistDEN.00205808CO

Practice location

11 Rossanley Dr
Medford, OR 97501-1713

Phone 541-797-6152

Mailing address

19700 E Parker Square Dr
Parker, CO 80134-7301

Other practice locations

19700 E Parker Square Dr
Parker, CO 80134-7301

Phone 720-605-1696

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