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Individual

DR. BRYANT CORNELIUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS, MBA, MPH

Contact information

Practice address
260 TOLLGATE RD, ZELIENOPLE, PA 16063-3030
(970) 260-8629
Mailing address
260 TOLLGATE RD, ZELIENOPLE, PA 16063-3030
(970) 260-8629

Taxonomy

Speciality
Code
Description
License number
State
1223D0004X
Dental Anesthesiology
Primary
30.024998
OH
1223D0004X
Dental Anesthesiology
DS039600
PA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
30024998
OH

Other

Enumeration date
01/24/2007
Last updated
12/18/2019
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