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NPI Code Detail

MEDICARE: DR. DAVID GLENN KEMP D.D.S.

MEDICARE: DR. DAVID GLENN KEMP D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist014012GA

General Provider Information

NPI Number : 1538167069
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID GLENN KEMP D.D.S.
Provider Business Mailing Address
First Line : 4030 WINDER HWY
Second Line :
City : FLOWERY BRANCH
State : GA
Zip : 30542-3021
Country : US
Telephone Number : 678-960-3440
Fax Number : 678-960-3445
Provider Business Practice Location Address
First Line : 4030 WINDER HWY
Second Line :
City : FLOWERY BRANCH
State : GA
Zip : 30542-3021
Country : US
Telephone Number : 678-960-3440
Fax Number : 678-960-3445
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2005
Last Update Date : 01/18/2017

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