Cumming Dental Associates
Dentist, General Practice in Cumming, GA. Organization (NPI-2).
NPI number1255464384
StatusActive
Last updated in NPPESMar 17, 2018
Details
- NPI
- 1255464384
- Entity type
- Organization (NPI-2)
- Legal business name
- Cumming Dental Associates
- Organization subpart
- No
- Enumeration date
- Mar 14, 2007
- Last updated
- Mar 17, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | DN011242 | GA | Yes |
| 122300000X | Dentist | DN014775 | GA | |
| 122300000X | Dentist | Dn015174 | GA | |
| 122300000X | Dentist | – | – | |
| 1223G0001X | Dentist, General Practice | DN012306 | GA | |
| 1223G0001X | Dentist, General Practice | DN011760 | GA | |
| 1223G0001X | Dentist, General Practice | DN012514 | GA | |
| 1223G0001X | Dentist, General Practice | DN015212 | GA | |
| 1223X0400X | Dentist, Orthodontics and Dentofacial Orthopedics | DN011424 | GA |
Practice location
1200 Bald Ridge Marina RdSuite 200
Cumming, GA 30041-8494
Phone 770-781-8650 · Fax 770-781-2953
Mailing address
Po Box 599Cumming, GA 30028-0599
Phone 770-781-8650 · Fax 770-781-2953
Other practice locations
Authorized official
Kevin Short
Owner
7707818650
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