Provider Demographics
NPI:1033202304
Name:CORLEY, WILLIAM ABNEY (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ABNEY
Last Name:CORLEY
Suffix:
Gender:M
Credentials:DDS
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 ABRIENDO AVE
Mailing Address - Street 2:STE D
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81004-2377
Mailing Address - Country:US
Mailing Address - Phone:719-545-8422
Mailing Address - Fax:
Practice Address - Street 1:540 E ABRIENDO AVE
Practice Address - Street 2:SUITE D
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81004-2374
Practice Address - Country:US
Practice Address - Phone:719-545-8422
Practice Address - Fax:719-545-8422
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-01
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO100881122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist