Provider Demographics
NPI:1922021161
Name:KORE, DORIS R (DDS)
Entity Type:Individual
Prefix:DR
First Name:DORIS
Middle Name:R
Last Name:KORE
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 1:6927 BROCKTON AVE
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506
Mailing Address - Country:US
Mailing Address - Phone:951-787-6500
Mailing Address - Fax:951-787-6509
Practice Address - Street 1:6927 BROCKTON AVE
Practice Address - Street 2:SUITE 2B
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506
Practice Address - Country:US
Practice Address - Phone:951-787-6500
Practice Address - Fax:951-787-6509
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA491261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice