Cherokee Family Dental, LLC
Dentist, General Practice in Canton, GA. Organization (NPI-2).
NPI number1194155986
StatusActive
Last updated in NPPESNov 15, 2013
Details
- NPI
- 1194155986
- Entity type
- Organization (NPI-2)
- Legal business name
- Cherokee Family Dental, LLC
- Organization subpart
- No
- Enumeration date
- Nov 15, 2013
- Last updated
- Nov 15, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | DN013366 | GA | Yes |
| 1223E0200X | Dentist, Endodontics | DN014617 | GA | |
| 1223G0001X | Dentist, General Practice | DN014219 | GA |
Practice location
2920 Marietta HwySuite 146
Canton, GA 30114-8212
Phone 770-704-6987
Mailing address
2920 Marietta HighwaySuite 146
Canton, GA 30114
Authorized official
Nicholas Johnson
Owner
7707046987
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