Provider Demographics
NPI:1376558726
Name:KORYLKO-CARNY, TAMMY ANN (DDS)
Entity Type:Individual
Prefix:DR
First Name:TAMMY
Middle Name:ANN
Last Name:KORYLKO-CARNY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:TAMMY
Other - Middle Name:ANN
Other - Last Name:KORYLKO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:4769 GATEWAY DR
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256
Mailing Address - Country:US
Mailing Address - Phone:330-722-3661
Mailing Address - Fax:
Practice Address - Street 1:418 NORTHEAST AVENUE
Practice Address - Street 2:
Practice Address - City:TALLMADGE
Practice Address - State:OH
Practice Address - Zip Code:44278
Practice Address - Country:US
Practice Address - Phone:330-633-5002
Practice Address - Fax:330-633-5462
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30021327122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist