Individual
DR. CORY AUSTIN DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
520 POPE AVE, FORT LEAVENWORTH, KS 66027-2332
(913) 684-5516
Mailing address
15217 WOODSON ST, OVERLAND PARK, KS 66223-3249
(714) 875-5800
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
61924
KS
Other
Enumeration date
08/11/2021
Last updated
08/11/2021
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