Individual
CORINNE ELLEN TABERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
29795 THREE NOTCH RD, CHARLOTTE HALL, MD 20622-4106
(301) 290-0001
Mailing address
21676 POTOMAC VIEW DR, LEONARDTOWN, MD 20650-2134
(402) 202-4148
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
63964
CA
1223G0001X
General Practice Dentistry
0401411905
VA
Other
Enumeration date
10/25/2007
Last updated
03/17/2018
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