Provider Demographics
NPI:1699860429
Name:HUTSON E. MCCORKLE, D.D.S.,P.A.
Entity Type:Organization
Organization Name:HUTSON E. MCCORKLE, D.D.S.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HUTSON
Authorized Official - Middle Name:EDWIN
Authorized Official - Last Name:MCCORKLE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:407-422-3131
Mailing Address - Street 1:605 DELANEY AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-3825
Mailing Address - Country:US
Mailing Address - Phone:407-422-3131
Mailing Address - Fax:407-422-3134
Practice Address - Street 1:605 DELANEY AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-3825
Practice Address - Country:US
Practice Address - Phone:407-422-3131
Practice Address - Fax:407-422-3134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty