Provider Demographics
NPI:1841204039
Name:CORNISH, C GRAF (DDS)
Entity Type:Individual
Prefix:DR
First Name:C
Middle Name:GRAF
Last Name:CORNISH
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 1:1189 S PERRY ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-1958
Mailing Address - Country:US
Mailing Address - Phone:303-688-3398
Mailing Address - Fax:303-688-3846
Practice Address - Street 1:1189 S PERRY ST
Practice Address - Street 2:SUITE 250
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-1958
Practice Address - Country:US
Practice Address - Phone:303-688-3398
Practice Address - Fax:303-688-3846
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO29281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice