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General NPI Number Information
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NPI Number | 1215340005
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Entity Type | Individual
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Provider Name | NATHAN A. CORN D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 06/09/2014
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 884 W JEFFERSON ST
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City | FRANKLIN
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State | IN
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Zip | 46131-2120
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Country | US
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Telephone | 317-736-9546
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Fax |
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Provider Business Mailing Address
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Address Line | 2072 S US HIGHWAY 231
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City | BLOOMFIELD
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State | IN
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Zip | 47424-7511
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Country | US
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Telephone | 812-381-1520
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 12012165A
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License Number State | IN
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