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General NPI Number Information
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NPI Number | 1417160342
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Entity Type | Individual
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Provider Name | SIDNEY KIRK CUNNINGHAM DDS
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Gender | Male
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 801 E WILLIAM CANNON DR SUITE 230
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City | AUSTIN
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State | TX
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Zip | 78745-6646
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Country | US
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Telephone | 512-447-3501
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Fax | 512-447-1811
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Provider Business Mailing Address
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Address Line | 801 E WILLIAM CANNON DR SUITE 230
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City | AUSTIN
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State | TX
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Zip | 78745-6646
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Country | US
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Telephone | 512-447-3501
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Fax | 512-447-1811
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 16135
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License Number State | TX
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