MEDICARE: DR. CORI ALAINE FINE DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DDS111909	CA

General Provider Information

NPI Number	:	1669161469
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CORI ALAINE FINE DMD

Provider Business Mailing Address
First Line	:	8130 W 83RD ST APT 3
Second Line	:
City	:	PLAYA DEL REY
State	:	CA
Zip	:	90293-7851
Country	:	US
Telephone Number	:	845-709-5828
Fax Number	:

Provider Business Practice Location Address
First Line	:	1559 PACIFIC COAST HWY
Second Line	:
City	:	HERMOSA BEACH
State	:	CA
Zip	:	90254-3214
Country	:	US
Telephone Number	:	310-372-7686
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2023
Last Update Date	:	05/28/2026

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