Provider Demographics
NPI:1417092123
Name:CORDON, NOLAN E (DMD MS)
Entity Type:Individual
Prefix:
First Name:NOLAN
Middle Name:E
Last Name:CORDON
Suffix:
Gender:M
Credentials:DMD MS
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:30012 N CAVE CREEK RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CAVE CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85331
Mailing Address - Country:US
Mailing Address - Phone:480-563-8926
Mailing Address - Fax:480-419-3558
Practice Address - Street 1:30012 N CAVE CREEK RD
Practice Address - Street 2:SUITE 102
Practice Address - City:CAVE CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85331
Practice Address - Country:US
Practice Address - Phone:480-563-8926
Practice Address - Fax:480-419-3558
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ47361223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics