Individual
DR. CORNELIUS HOMER DANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2239 HIGHWAY 20 SE STE H, CONYERS, GA 30013-2087
(770) 921-3565
(770) 921-3534
Mailing address
3202 HALEYS WAY SE, CONYERS, GA 30013-6445
(404) 216-0023
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN015921
GA
Other
Enumeration date
07/10/2019
Last updated
07/10/2019
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