Organization
CUMMING PEDIATRIC DENTISTRY & ORTHODONTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA MONELL (BUSINESS MANAGER)
(770) 781-8650
Entity
Organization
Contact information
Practice address
3275 MARKET PLACE BLVD STE 150, CUMMING, GA 30041-7980
(770) 781-8650
Mailing address
3275 MARKET PLACE BLVD STE 150, CUMMING, GA 30041-7980
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
015146
GA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
011424
GA
Other
Enumeration date
01/04/2018
Last updated
01/04/2018
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