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General NPI Number Information
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NPI Number | 1790857076
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Entity Type | Individual
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Provider Name | ROBERT THOMAS CORTE DDS
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Gender | Male
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3 S WAIOLA AVE
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City | LA GRANGE
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State | IL
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Zip | 60525-2255
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Country | US
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Telephone | 708-354-1003
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Fax |
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Provider Business Mailing Address
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Address Line | 329 DOVER AVE
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City | LA GRANGE PARK
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State | IL
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Zip | 60526-1704
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Country | US
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Telephone | 708-482-0435
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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 | 5592
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 3283-015
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2002005743
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 1926
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License Number State | ND
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Taxonomy #5
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State | IL
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