Provider Demographics
NPI:1740302462
Name:CARVILLE, KORIN E (DDS)
Entity type:Individual
Prefix:DR
First Name:KORIN
Middle Name:E
Last Name:CARVILLE
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 1:8 BUSINESS PARK CT
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-6308
Mailing Address - Country:US
Mailing Address - Phone:315-732-4688
Mailing Address - Fax:315-738-7140
Practice Address - Street 1:8 BUSINESS PARK CT
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-6308
Practice Address - Country:US
Practice Address - Phone:315-732-4688
Practice Address - Fax:315-738-7140
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0470181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice