Individual
JOHN SANFORD BIRCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1024 MARKET PLACE BLVD, CUMMING, GA 30041
(770) 844-6771
(770) 844-6686
Mailing address
1024 MARKET PLACE BLVD, CUMMING, GA 30041
(770) 844-6771
(770) 844-6686
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN010113
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00353812D
—
GA
Enumeration date
01/11/2008
Last updated
01/11/2008
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