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Individual

DR. CHANCEY B. C. WASHBURN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
1100 NORTHSIDE FORSYTH DR, SUITE 420, CUMMING, GA 30041-6012
(678) 455-4560
Mailing address
410 PEACHTREE PKWY, STE 4204, CUMMING, GA 30041-7439
(678) 455-4560
(678) 455-9628

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN 012398
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000929475A
GA
Enumeration date
09/21/2006
Last updated
03/17/2016
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