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General NPI Number Information
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NPI Number | 1194832428
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Entity Type | Individual
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Provider Name | COREY DEEBLE DDS
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Gender | Male
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Dates
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Enumeration Date | 08/24/2006
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Last Update Date | 02/13/2008
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Provider Practice Location Address
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Address Line | 3551 FLORISTA ST #1C
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City | LOS ALAMITOS
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State | CA
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Zip | 90720-2474
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Country | US
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Telephone | 562-596-1661
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Fax |
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Provider Business Mailing Address
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Address Line | 2803 JOSIE AVE
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City | LONG BEACH
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State | CA
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Zip | 90815-1515
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Country | US
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Telephone | 562-429-9192
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 54135
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License Number State | CA
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