Healthcare Provider Details

I. General information

NPI: 1205823689
Provider Name (Legal Business Name): DAVID EDWARD CORMAN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 MDG UNIT 3215
APO AE
09094
DE

IV. Provider business mailing address

CMR 442 BOX 921
APO AE
09042
DE

V. Phone/Fax

Practice location:
  • Phone: 01149637146
  • Fax:
Mailing address:
  • Phone: 01149637146
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDEN-6074
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number4981
License Number StateNE
# 3
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number5765
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: