Provider Demographics
NPI:1659467975
Name:CORBETT, JEFFREY D (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:D
Last Name:CORBETT
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 1:1 POST OFFICE SQ
Mailing Address - Street 2:LYNNFIELD MEDICAL BUILDING
Mailing Address - City:LYNNFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01940-2218
Mailing Address - Country:US
Mailing Address - Phone:781-592-9779
Mailing Address - Fax:781-592-5780
Practice Address - Street 1:1 POST OFFICE SQ
Practice Address - Street 2:LYNNFIELD MEDICAL BUILDING
Practice Address - City:LYNNFIELD
Practice Address - State:MA
Practice Address - Zip Code:01940-2218
Practice Address - Country:US
Practice Address - Phone:781-592-9779
Practice Address - Fax:781-592-5780
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA169641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice