Provider Demographics
NPI:1720334840
Name:RESCHENTHALER, CORINNE D (DMD)
Entity Type:Individual
Prefix:
First Name:CORINNE
Middle Name:D
Last Name:RESCHENTHALER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3637 NW BYRON ST
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-9127
Mailing Address - Country:US
Mailing Address - Phone:708-899-6620
Mailing Address - Fax:
Practice Address - Street 1:3637 NW BYRON ST
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-9127
Practice Address - Country:US
Practice Address - Phone:708-899-6620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-26
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190291361223G0001X
WA60578324122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice