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General NPI Number Information
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NPI Number | 1730353426
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Entity Type | Organization
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Legal Business Name | NEIL R. CORNELL, D.D.S.
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Dates
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Enumeration Date | 04/15/2008
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Last Update Date | 04/15/2008
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Provider Practice Location Address
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Address Line | 3040 BRIARCLIFF RD NE
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City | ATLANTA
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State | GA
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Zip | 30329-2602
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Country | US
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Telephone | 404-636-5646
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Fax |
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Provider Business Mailing Address
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Address Line | 3040 BRIARCLIFF RD NE
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City | ATLANTA
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State | GA
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Zip | 30329-2602
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Country | US
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Telephone | 404-636-5646
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Fax |
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Authorized Official
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Title or Position | BUSINESS OWNER
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Name | DR. NEIL R CORNELL
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Credential |
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Telephone | 404-636-5646
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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 | DN012098
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License Number State | GA
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