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General NPI Number Information
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NPI Number | 1710053889
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Entity Type | Individual
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Provider Name | CORRINN JESSICA COSAERT DDS
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Gender | Female
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 08/25/2008
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Provider Practice Location Address
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Address Line | 275 CENTURY CIR STE 275
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City | LOUISVILLE
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State | CO
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Zip | 80027-9729
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Country | US
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Telephone | 303-666-4499
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Fax | 303-666-2119
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Provider Business Mailing Address
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Address Line | 11895 PERRY ST
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City | WESTMINSTER
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State | CO
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Zip | 80031
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Country | US
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Telephone | 720-940-4355
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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 | 8931
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License Number State | CO
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