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General NPI Number Information
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NPI Number | 1588529606
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Entity Type | Organization
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Legal Business Name | KUZHY DENTAL LLC
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Dates
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Enumeration Date | 12/20/2025
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Last Update Date | 12/20/2025
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Provider Practice Location Address
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Address Line | 780 SCENIC HWY
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-6365
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Country | US
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Telephone | 678-215-1300
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Fax |
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Provider Business Mailing Address
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Address Line | 1204 RED BUD RD NE
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City | CALHOUN
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State | GA
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Zip | 30701-9294
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Country | US
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Telephone | 770-356-4342
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | RON S CHEMMALAKUZHY
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Credential | DMD
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Telephone | 770-356-4342
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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