Provider Demographics
NPI:1235395807
Name:PADILLA, FERDINAND CINTRON (DMD)
Entity Type:Individual
Prefix:DR
First Name:FERDINAND
Middle Name:CINTRON
Last Name:PADILLA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 HENRY ST
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30904-4653
Mailing Address - Country:US
Mailing Address - Phone:706-414-6904
Mailing Address - Fax:
Practice Address - Street 1:1459 LANEY WALKER BLVD
Practice Address - Street 2:SCHOOL OF DENTISTRY
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30912-1210
Practice Address - Country:US
Practice Address - Phone:706-721-2716
Practice Address - Fax:706-721-1893
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN013775122300000X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist