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Contact Information

JESSICA L CORCORAN, DDS
121 20TH ST NW
WAVERLY, IA50677
 Phone: 319-352-5281
 Fax: 319-352-0509
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for JESSICA L CORCORAN · (Female)

NPI Number 1093844573
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 03/02/2007
Last updated 05/01/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • IA License # 08339
  • IA Medicaid 0728550
  • IA Medicaid 1728550
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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