Provider Demographics
NPI:1376640458
Name:DEL CORE, BRIAN (DDS)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:DEL CORE
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 1:783 RIO DEL MAR BLVD
Mailing Address - Street 2:SUITE 71-A
Mailing Address - City:APTOS
Mailing Address - State:CA
Mailing Address - Zip Code:95003-4771
Mailing Address - Country:US
Mailing Address - Phone:831-688-3012
Mailing Address - Fax:831-688-3024
Practice Address - Street 1:783 RIO DEL MAR BLVD
Practice Address - Street 2:SUITE 71-A
Practice Address - City:APTOS
Practice Address - State:CA
Practice Address - Zip Code:95003-4771
Practice Address - Country:US
Practice Address - Phone:831-688-3012
Practice Address - Fax:831-688-3024
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0346891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice