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NPI Code Detail

MEDICARE: DR. CORBIN A. GATLIN DDS, MD

MEDICARE:  DR. CORBIN A. GATLIN  DDS, MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1204E00000XOral & Maxillofacial Surgery (D.M.D.)30580TX

General Provider Information

NPI Number : 1538504741
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CORBIN A. GATLIN DDS, MD
Provider Business Mailing Address
First Line : 103 BURNETT CT
Second Line :
City : WACO
State : TX
Zip : 76712-3100
Country : US
Telephone Number : 254-399-9925
Fax Number :
Provider Business Practice Location Address
First Line : 103 BURNETT CT
Second Line :
City : WACO
State : TX
Zip : 76712-3100
Country : US
Telephone Number : 254-399-9925
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2013
Last Update Date : 06/22/2019

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Directions to “ DR. CORBIN A. GATLIN DDS, MD” Practice Location

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