Provider Demographics
NPI:1194953406
Name:STRINGFELLOW, CORBIN B (DMD)
Entity type:Individual
Prefix:
First Name:CORBIN
Middle Name:B
Last Name:STRINGFELLOW
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1345 E 3900 S STE 208
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84124-4416
Mailing Address - Country:US
Mailing Address - Phone:801-272-8284
Mailing Address - Fax:801-277-4387
Practice Address - Street 1:1345 E 3900 S STE 208
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84124-4416
Practice Address - Country:US
Practice Address - Phone:801-272-8284
Practice Address - Fax:801-277-4387
Is Sole Proprietor?:No
Enumeration Date:2009-06-24
Last Update Date:2009-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT738-3796-99221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice