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COOSA DENTAL ASSOCIATES LLC NPI 1326258351


NPI Information

NPI: 1326258351
Provider Name: COOSA DENTAL ASSOCIATES, LLC
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
109 EAST AVE
CEDARTOWN, GA
ZIP 30125
Phone: (770) 748-7736
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COOSA DENTAL ASSOCIATES, LLC is a general practice dentist in Cedartown, GA. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. COOSA DENTAL ASSOCIATES, LLC NPI is 1326258351. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

109 EAST AVE
CEDARTOWN, GA
ZIP 30125-921
Phone: (770) 748-7736
Fax: (770) 748-4015

The provider's authorized official is David Bradford Gandy .
The authorized official title is Dentist and has the following contact phone number (770) 748-7736.

The enumeration date for this NPI number is 5/22/2007 and was last updated on 11/19/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral PracticeDN010447GEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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