Provider Demographics
NPI:1154460277
Name:EYLANDER, CORBIN CHARLES (DDS)
Entity Type:Individual
Prefix:DR
First Name:CORBIN
Middle Name:CHARLES
Last Name:EYLANDER
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 1:9125 BRIDGEPORT WAY SW
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-2448
Mailing Address - Country:US
Mailing Address - Phone:253-581-6140
Mailing Address - Fax:253-589-5417
Practice Address - Street 1:9125 BRIDGEPORT WAY SW
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-2448
Practice Address - Country:US
Practice Address - Phone:253-581-6140
Practice Address - Fax:253-589-5417
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA51201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice