Provider Demographics
NPI:1073621348
Name:CORNER, ERNEST W JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ERNEST
Middle Name:W
Last Name:CORNER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1353 WARWICK AVE
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02888
Mailing Address - Country:US
Mailing Address - Phone:401-463-5480
Mailing Address - Fax:401-463-7601
Practice Address - Street 1:1353 WARWICK AVE
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02888
Practice Address - Country:US
Practice Address - Phone:401-463-5480
Practice Address - Fax:401-463-7601
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRI1875DEN1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice