Ks Az-1, Pc is a Endodontics in Marietta, Georgia. Ks Az-1, Pc practices all healthcare services and medical treatments related to Endodontics. The NPI Number for Ks Az-1, Pc is 1588759161. The last update date is 2014-12-17.
Ks Az-1, Pc's current location address is 1090 Northchase Pkwy Se Ste 150, Marietta, Georgia. You can contact this provider via phone number 7709165028 and fax number 6782477858. The mailing address for Ks Az-1, Pc is 1090 Northchase Pkwy Se Ste 150, Marietta, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Ks Az-1, Pc |
|---|---|
| Address | 1090 Northchase Pkwy Se Ste 150, Marietta, Georgia |
| Phone Number | 7709165028 |
| Fax Number | 6782477858 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Mayfield Dale |
| Credentials | DMD |
| Telephone Number | 7709165028 |
NPI Number Detail
| NPI Number | 1588759161 |
|---|---|
| Provider Enumeration Date | 2006-10-03 |
| Last Updated Date | 2014-12-17 |
Provider Mailing Address Detail
| Address | 1090 Northchase Pkwy Se Ste 150 |
|---|---|
| City | Marietta |
| State | Georgia (GA) |
| Post Code | 300676407 |
| Phone Number | 7709165028 |
| Fax Number | 6782477858 |
Provider's Primary Taxonomy Detail
| Speciality | Endodontics |
|---|---|
| Taxonomy | 1223E0200X |
|
Definition: The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the eti |
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What is the unique 10-digit identification code issued to Ks Az-1, Pc by the Centers for Medicare & Medicaid Services?
The Ks Az-1, Pc has been assigned the NPI (National Provider Identifier) 1588759161 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you provide the complete physical address where Ks Az-1, Pc is located?
The Ks Az-1, Pc is situated at the following address: 1090 Northchase Pkwy Se Ste 150, Marietta, GA, 300676407.
What is the area of specialization for Ks Az-1, Pc, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Ks Az-1, Pc is Endodontics, and the corresponding taxonomy code that categorizes this area of expertise is 1223E0200X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1588759161 to Ks Az-1, Pc?
The Centers for Medicare & Medicaid Services originally issued the 1588759161 to Ks Az-1, Pc on 2006-10-03.
As of what date was the information regarding Ks Az-1, Pc, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Ks Az-1, Pc, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2014-12-17.