MEDICARE: CS DENTAL ASSOCIATES, P.C.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	122300000X	Dentist
2	1223E0200X	Endodontics
3	1223P0300X	Periodontics
4	1223S0112X	Oral and Maxillofacial Surgery (Dentist)
5	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1639769201
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CS DENTAL ASSOCIATES, P.C.

Provider Business Mailing Address
First Line	:	1175 PEACHTREE ST NE STE 1210
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30361-3544
Country	:	US
Telephone Number	:	404-482-2550
Fax Number	:

Provider Business Practice Location Address
First Line	:	1175 PEACHTREE ST NE STE 1210
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30361-3544
Country	:	US
Telephone Number	:	404-874-6464
Fax Number	:

Authorized Official
Title or Position	:	SECRETARY
Name	:	BENJAMIN CUTLER
Credential	:
Telephone Number	:	404-482-2550

Provider Enumeration Date	:	01/19/2021
Last Update Date	:	05/12/2022

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