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General NPI Number Information
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NPI Number | 1891936944
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Entity Type | Individual
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Provider Name | GEOFFREY ROSS CUNNINGHAM DDS, MS
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Gender | Male
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Dates
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Enumeration Date | 03/19/2009
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Last Update Date | 03/19/2009
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Provider Practice Location Address
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Address Line | 35 E BENJAMIN DR
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City | NEW MARTINSVILLE
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State | WV
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Zip | 26155-2705
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Country | US
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Telephone | 304-455-5644
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Fax |
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Provider Business Mailing Address
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Address Line | 1240 VAN VOORHIS RD APT L3
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City | MORGANTOWN
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State | WV
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Zip | 26505-7903
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Country | US
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Telephone | 704-224-9083
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Fax |
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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 | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 3470
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 7260
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License Number State | NC
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