Provider Demographics
NPI:1710667779
Name:CORSO, MARGARET GRACE (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:GRACE
Last Name:CORSO
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 1:188 COLLEGE PARK DR APT 332
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76086-6608
Mailing Address - Country:US
Mailing Address - Phone:708-548-7907
Mailing Address - Fax:
Practice Address - Street 1:2206 STATE HIGHWAY 16 S
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:TX
Practice Address - Zip Code:76450-4616
Practice Address - Country:US
Practice Address - Phone:940-291-3007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX398601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice