Organization
DAVID J CASSIDY DMD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID J CASSIDY (OWNER)
(706) 226-8706
Entity
Organization
Contact information
Practice address
1403 DUG GAP RD, DALTON, GA 30720-5008
(706) 226-8706
Mailing address
1403 DUG GAP RD, DALTON, GA 30720-5008
(706) 226-8706
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
9623
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00288549A
—
GA
01
—
9182270
WELLCARE
GA
Enumeration date
04/01/2008
Last updated
04/01/2008
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