Provider Demographics
NPI:1902939036
Name:CORBETT, DANA N (DMD)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:N
Last Name:CORBETT
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 E MAIN ST STE 125
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40508-2328
Mailing Address - Country:US
Mailing Address - Phone:859-252-0808
Mailing Address - Fax:
Practice Address - Street 1:540 E MAIN ST STE 125
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40508-2328
Practice Address - Country:US
Practice Address - Phone:858-252-0808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY74871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice