Provider Demographics
NPI:1285831768
Name:WILLIAM P. CORNILS DDS,PC
Entity Type:Organization
Organization Name:WILLIAM P. CORNILS DDS,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:P
Authorized Official - Last Name:CORNILS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:765-489-4440
Mailing Address - Street 1:449 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:47346-1331
Mailing Address - Country:US
Mailing Address - Phone:765-489-4440
Mailing Address - Fax:765-489-4440
Practice Address - Street 1:449 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:IN
Practice Address - Zip Code:47346-1331
Practice Address - Country:US
Practice Address - Phone:765-489-4440
Practice Address - Fax:765-489-4440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12007331122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty