Provider Demographics
NPI:1912130733
Name:CORCORAN, TOBIAS WILSON (DDS)
Entity Type:Individual
Prefix:DR
First Name:TOBIAS
Middle Name:WILSON
Last Name:CORCORAN
Suffix:
Gender:M
Credentials:DDS
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Other - Credentials:
Mailing Address - Street 1:607 OAKWOOD AVE
Mailing Address - Street 2:AURORA SMILES PEDIATRIC DENTISTRY
Mailing Address - City:EAST AURORA
Mailing Address - State:NY
Mailing Address - Zip Code:14052
Mailing Address - Country:US
Mailing Address - Phone:716-710-2888
Mailing Address - Fax:716-805-7001
Practice Address - Street 1:607 OAKWOOD AVE
Practice Address - Street 2:AURORA SMILES PEDIATRIC DENTISTRY
Practice Address - City:EAST AURORA
Practice Address - State:NY
Practice Address - Zip Code:14052-2354
Practice Address - Country:US
Practice Address - Phone:716-710-2888
Practice Address - Fax:716-805-7001
Is Sole Proprietor?:No
Enumeration Date:2009-08-27
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0540001223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry