Individual
DR. KHALIL DANIEL CUMBERBATCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3660 FLAT SHOALS RD, STE 100, DECATUR, GA 30034-1635
(404) 243-0217
Mailing address
3660 FLAT SHOALS RD, STE 100, DECATUR, GA 30034-1635
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN013502
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN013502
STATE DENTAL LICENCE
GA
Enumeration date
05/23/2007
Last updated
03/10/2016
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