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General NPI Number Information
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NPI Number | 1447412754
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Entity Type | Organization
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Legal Business Name | CABELL DENTAL GROUP LLC
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Dates
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Enumeration Date | 06/27/2008
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Last Update Date | 12/09/2010
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Provider Practice Location Address
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Address Line | 990 BEAR CREEK BLVD SUITE E
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City | HAMPTON
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State | GA
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Zip | 30228-1864
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Country | US
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Telephone | 770-707-7905
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Fax | 770-707-7923
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Provider Business Mailing Address
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Address Line | 990 BEAR CREEK BLVD SUITE E
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City | HAMPTON
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State | GA
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Zip | 30228
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Country | US
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Telephone | 770-707-7905
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Fax | 770-707-7923
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Authorized Official
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Title or Position | GENERAL DENTIST
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Name | DR. MARJORIE MAE CABELL
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Credential | DMD
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Telephone | 770-707-7905
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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 |
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License Number State |
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