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NPI Code Detail

MEDICARE: DR. SHERYL RAE KORTRIGHT DDS

MEDICARE: DR. SHERYL RAE KORTRIGHT DDS
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
11223G0001XGeneral Practice DentistryDG34716CA

General Provider Information

NPI Number : 1972617033
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHERYL RAE KORTRIGHT DDS
Provider Business Mailing Address
First Line : 77 MORAGA WAY
Second Line : SUITE E
City : ORINDA
State : CA
Zip : 94563-3048
Country : US
Telephone Number : 925-254-4043
Fax Number :
Provider Business Practice Location Address
First Line : 77 MORAGA WAY
Second Line : SUITE E
City : ORINDA
State : CA
Zip : 94563-3019
Country : US
Telephone Number : 925-254-4043
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2006
Last Update Date : 07/08/2007

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