Provider Demographics
NPI:1306005483
Name:RAINFORD, CHEA ONAR (DMD)
Entity Type:Individual
Prefix:
First Name:CHEA
Middle Name:ONAR
Last Name:RAINFORD
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 1:5015 FLOYD RD SW
Mailing Address - Street 2:530
Mailing Address - City:MABLETON
Mailing Address - State:GA
Mailing Address - Zip Code:30126-1673
Mailing Address - Country:US
Mailing Address - Phone:404-810-1100
Mailing Address - Fax:
Practice Address - Street 1:5015 FLOYD RD SW
Practice Address - Street 2:530
Practice Address - City:MABLETON
Practice Address - State:GA
Practice Address - Zip Code:30126-1673
Practice Address - Country:US
Practice Address - Phone:404-810-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-04
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN013717122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist