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General NPI Number Information
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NPI Number | 1801998919
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Entity Type | Individual
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Provider Name | CHARLEY A CHENEY III DMD
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Gender | Male
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Dates
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Enumeration Date | 09/01/2006
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Last Update Date | 06/26/2012
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Provider Practice Location Address
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Address Line | 2819 HIGHWAY 34 E
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City | NEWNAN
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State | GA
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Zip | 30265-1331
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Country | US
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Telephone | 770-254-8787
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Fax | 800-556-4889
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Provider Business Mailing Address
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Address Line | PO BOX 73434
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City | NEWNAN
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State | GA
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Zip | 30271-3434
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Country | US
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Telephone | 770-254-8787
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Fax | 877-556-4889
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DN013135
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License Number State | GA
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