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General NPI Number Information
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NPI Number | 1346259546
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Entity Type | Individual
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Provider Name | DEBORAH BEVILL CORKRAN DDS
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Gender | Female
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 04/23/2008
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Provider Practice Location Address
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Address Line | 2717 BELLEVUE AVE
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City | SYRACUSE
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State | NY
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Zip | 13219-3233
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Country | US
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Telephone | 315-476-3291
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Fax | 315-476-8924
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Provider Business Mailing Address
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Address Line | 2717 BELLEVUE AVE
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City | SYRACUSE
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State | NY
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Zip | 13219-3233
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Country | US
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Telephone | 315-476-3291
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Fax | 315-476-8924
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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 | 04567
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 045674
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License Number State | NY
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