MEDICARE: DR. ELIZABETH DENSLOW CAUGHEY D.D.S.

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
1	1223G0001X	General Practice Dentistry	012227	GA

General Provider Information

NPI Number	:	1982618286
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELIZABETH DENSLOW CAUGHEY D.D.S.

Provider Business Mailing Address
First Line	:	5775 PEACHTREE DUNWOODY RD NE
Second Line	:	SUITE D-400
City	:	ATLANTA
State	:	GA
Zip	:	30342-1556
Country	:	US
Telephone Number	:	770-393-9201
Fax Number	:	770-393-9266

Provider Business Practice Location Address
First Line	:	5775 PEACHTREE DUNWOODY RD NE
Second Line	:	SUITE D-400
City	:	ATLANTA
State	:	GA
Zip	:	30342-1556
Country	:	US
Telephone Number	:	770-393-9201
Fax Number	:	770-393-9266

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2006
Last Update Date	:	07/08/2007

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