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NPI Code Detail

MEDICARE: EAST COBB FAMILY DENTISTRY, P.C.

MEDICARE: EAST COBB FAMILY DENTISTRY, P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry10725GA

General Provider Information

NPI Number : 1184650350
Entity Type Code : Organization
Provider Name (Legal Business Name) : EAST COBB FAMILY DENTISTRY, P.C.
Provider Business Mailing Address
First Line : 2969 JOHNSON FERRY RD
Second Line :
City : MARIETTA
State : GA
Zip : 30062-5653
Country : US
Telephone Number : 770-992-2340
Fax Number : 770-587-0240
Provider Business Practice Location Address
First Line : 2969 JOHNSON FERRY RD
Second Line :
City : MARIETTA
State : GA
Zip : 30062-5653
Country : US
Telephone Number : 770-992-2340
Fax Number : 770-587-0240
Authorized Official
Title or Position : PRESIDENT
Name : DR. DAVID C. HAYDON
Credential : DDS
Telephone Number : 770-992-2340
Provider Enumeration Date : 06/23/2006
Last Update Date : 08/22/2020

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1588915581 — EAST COBB FAMILY DENTISTRY
Practice Location Address:
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30062-5653
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Directions to “EAST COBB FAMILY DENTISTRY, P.C. ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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