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General NPI Number Information
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NPI Number | 1710082110
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Entity Type | Individual
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Provider Name | WILLIAM CHRISTOPHER CORNMAN D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1911 N AUSTIN AVENUE SUITE 405
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City | GEORGETOWN
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State | TX
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Zip | 78626
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Country | US
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Telephone | 512-869-8867
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Fax | 512-819-0480
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Provider Business Mailing Address
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Address Line | 1911 N AUSTIN AVENUE SUITE 405
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City | GEORGETOWN
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State | TX
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Zip | 78626
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Country | US
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Telephone | 512-869-8867
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Fax | 512-819-0480
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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 | 18714
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License Number State | TX
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