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General NPI Number Information
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NPI Number | 1962532184
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Entity Type | Organization
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Legal Business Name | JOHN M. CORNALI, DDS, P.C.
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8010 PALOMAS AVE NE SUITE A
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-5201
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Country | US
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Telephone | 505-828-1244
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Fax | 505-828-1447
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Provider Business Mailing Address
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Address Line | 8010 PALOMAS AVE NE SUITE A
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-5201
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Country | US
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Telephone | 505-828-1244
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN M. CORNALI
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Credential | DDS, MS
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Telephone | 505-828-1244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 1396
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License Number State | NM
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