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NPI Code Detail

MEDICARE: DR. KENT HEREFORD PERCY DDS

MEDICARE: DR. KENT HEREFORD PERCY DDS
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 Dentistry10919GA

General Provider Information

NPI Number : 1558493072
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KENT HEREFORD PERCY DDS
Provider Business Mailing Address
First Line : 1000 WHITLOCK AVE NW
Second Line : SUITE # 380
City : MARIETTA
State : GA
Zip : 30064-5455
Country : US
Telephone Number : 770-425-4748
Fax Number : 770-425-4749
Provider Business Practice Location Address
First Line : 1000 WHITLOCK AVE NW
Second Line : SUITE 380
City : MARIETTA
State : GA
Zip : 30064-5455
Country : US
Telephone Number : 770-425-4748
Fax Number : 770-425-4749
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/10/2007
Last Update Date : 04/23/2008

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Directions to “ DR. KENT HEREFORD PERCY DDS” Practice Location

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