Provider Demographics
NPI:1477637106
Name:PRICE, KORVETTA METOYIA (DDS)
Entity Type:Individual
Prefix:
First Name:KORVETTA
Middle Name:METOYIA
Last Name:PRICE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5087 JUDITH ANN DR
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48504-1226
Mailing Address - Country:US
Mailing Address - Phone:517-282-7070
Mailing Address - Fax:
Practice Address - Street 1:5087 JUDITH ANN DR
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48504-1226
Practice Address - Country:US
Practice Address - Phone:517-282-7070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2008-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010188541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice