Provider Demographics
NPI:1649429325
Name:DANIEL R KORB, DDS, PA
Entity type:Organization
Organization Name:DANIEL R KORB, DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:KORB
Authorized Official - Suffix:SR
Authorized Official - Credentials:DDS
Authorized Official - Phone:973-540-1460
Mailing Address - Street 1:1 RASKIN ROAD
Mailing Address - Street 2:DANIEL R. KORB D.D.S., PA
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-2822
Mailing Address - Country:US
Mailing Address - Phone:973-540-1460
Mailing Address - Fax:973-540-9190
Practice Address - Street 1:1 RASKIN ROAD
Practice Address - Street 2:DANIEL R. KORB D.D.S., PA
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-2822
Practice Address - Country:US
Practice Address - Phone:973-540-1460
Practice Address - Fax:973-540-9190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D100865201122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty