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Individual
KITRINA G CORDELL
Active
Individual
KITRINA G CORDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS MS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2901018465
MI
122300000X
Dentist
P-123
LA
1223P0106X
Oral and Maxillofacial Pathology Dentistry
2901018465
MI
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
P-123
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1958112200
BCBS OF MI MED SURGICAL
MI
05
—
4500641
—
MI
05
—
4874070
—
MI
01
—
D184650
BCBS OF MI DENTAL
MI
Enumeration date
03/13/2007
Last updated
07/23/2010
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