Provider Demographics
NPI:1568479418
Name:CORBETT, MAURICE CLARK (DDS)
Entity Type:Individual
Prefix:DR
First Name:MAURICE
Middle Name:CLARK
Last Name:CORBETT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:48638 BARRYMORE ST
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-8573
Mailing Address - Country:US
Mailing Address - Phone:760-296-3242
Mailing Address - Fax:949-861-9192
Practice Address - Street 1:13425 BEACH BLVD STE A
Practice Address - Street 2:
Practice Address - City:LA MIRADA
Practice Address - State:CA
Practice Address - Zip Code:90638-3558
Practice Address - Country:US
Practice Address - Phone:562-947-9135
Practice Address - Fax:562-947-9186
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA151961223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics