MEDICARE: ALLISON WESTBROOK CORBETT DMD

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
1	1223G0001X	General Practice Dentistry	DN013466	GA

General Provider Information

NPI Number	:	1912020447
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLISON WESTBROOK CORBETT DMD

Provider Business Mailing Address
First Line	:	2970 PEACHTREE RD NW
Second Line	:	SUITE 665
City	:	ATLANTA
State	:	GA
Zip	:	30305-2192
Country	:	US
Telephone Number	:	404-816-7075
Fax Number	:	404-816-5469

Provider Business Practice Location Address
First Line	:	2970 PEACHTREE RD NW
Second Line	:	SUITE 665
City	:	ATLANTA
State	:	GA
Zip	:	30305-2192
Country	:	US
Telephone Number	:	404-816-7075
Fax Number	:	404-816-5469

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/09/2007
Last Update Date	:	07/08/2007

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