Provider Demographics
NPI:1639279813
Name:POSERT, CORAL ELISE (DDS)
Entity Type:Individual
Prefix:DR
First Name:CORAL
Middle Name:ELISE
Last Name:POSERT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:CORAL
Other - Middle Name:ELISE
Other - Last Name:COBLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1141 PEAR TREE LN STE 100
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-6485
Mailing Address - Country:US
Mailing Address - Phone:072-541-7707
Mailing Address - Fax:
Practice Address - Street 1:911 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:CALISTOGA
Practice Address - State:CA
Practice Address - Zip Code:94515-1433
Practice Address - Country:US
Practice Address - Phone:707-709-2308
Practice Address - Fax:707-254-1779
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36610122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist