# CUMBERLAND DENTURE DENTAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306903869
- **Authorized official:** MRS. SHELLY ANDERSON (OFFICE MANAGER)
- **Authorized official phone:** (606) 528-6104

## Contact information

- **Practice address:** 40 MOONBOW PLZ, SUITE 3, CORBIN, KY 40701-8982
- **Practice address phone:** (606) 528-6104
- **Practice address fax:** (606) 528-3982
- **Mailing address:** 40 MOONBOW PLZ, SUITE 3, CORBIN, KY 40701-8982
- **Mailing address phone:** (606) 528-6104
- **Mailing address fax:** (606) 528-3982

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 5198 | KY | Yes |

## Other

- **Enumeration date:** 01/03/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 61900783 | — | KY |