Individual
DR. THOMAS ALBERT KORBITZ
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
US HWY 491 NORTH, SHIPROCK, NM 87420
(505) 368-6020
(505) 368-6431
Mailing address
PO BOX 160, SHIPROCK, NM 87420-0160
(505) 368-6020
(505) 368-6431
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DD1508
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
18205305
—
NM
05
—
472118
—
AZ
05
—
95734040
—
CO
Enumeration date
10/14/2005
Last updated
07/08/2007
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