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General NPI Number Information
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NPI Number | 1851627103
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Entity Type | Organization
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Legal Business Name | TY C. CORBRIDGE, DMD, PC
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Dates
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Enumeration Date | 10/21/2009
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Last Update Date | 01/28/2026
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Provider Practice Location Address
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Address Line | 1607 HIGHWAY 2
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City | SANDPOINT
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State | ID
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Zip | 83864-1779
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Country | US
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Telephone | 208-265-1705
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Fax | 855-939-2028
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Provider Business Mailing Address
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Address Line | 1607 HIGHWAY 2
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City | SANDPOINT
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State | ID
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Zip | 83864-1779
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Country | US
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Telephone | 208-265-1705
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Fax | 855-939-2028
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Authorized Official
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Title or Position | CORPORATE SECRETARY
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Name | SHERRY M CORBRIDGE
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Credential |
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Telephone | 208-265-1705
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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