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General NPI Number Information
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NPI Number | 1710667779
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Entity Type | Individual
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Provider Name | MARGARET GRACE CORSO DDS
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Gender | Female
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Dates
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Enumeration Date | 07/24/2023
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Last Update Date | 07/24/2023
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Provider Practice Location Address
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Address Line | 2206 STATE HIGHWAY 16 S
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City | GRAHAM
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State | TX
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Zip | 76450-4616
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Country | US
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Telephone | 940-291-3007
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Fax |
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Provider Business Mailing Address
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Address Line | 188 COLLEGE PARK DR APT 332
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City | WEATHERFORD
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State | TX
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Zip | 76086-6608
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Country | US
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Telephone | 708-548-7907
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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 | 39860
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License Number State | TX
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