Individual
DR. JESSICA LILLIE CORCORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
121 20TH ST NW, WAVERLY, IA 50677
(319) 352-5281
(319) 352-0509
Mailing address
121 20TH ST NW, WAVERLY, IA 50677
(319) 352-5281
(319) 352-0509
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
08339
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0728550
—
IA
05
—
1728550
—
IA
Enumeration date
03/02/2007
Last updated
05/01/2020
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