# CORNILS FAMILY DENTISTRY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740551167
- **Authorized official:** DR. THOMAS CHASE CORNILS D.D.S. (OWNER/DENTIST)
- **Authorized official phone:** (765) 914-5089

## Contact information

- **Practice address:** 2016 W MCGALLIARD RD, MUNCIE, IN 47304-2148
- **Practice address phone:** (765) 284-7242
- **Mailing address:** 2016 W MCGALLIARD RD, MUNCIE, IN 47304-2148
- **Mailing address phone:** (765) 284-7242

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 12011436A | IN | Yes |

## Other

- **Enumeration date:** 01/17/2012
- **Last updated:** 01/17/2012