Provider Demographics
NPI:1477080232
Name:THOMAS W. KAUFFMAN, DDS, PC
Entity Type:Organization
Organization Name:THOMAS W. KAUFFMAN, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:W
Authorized Official - Last Name:KAUFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:404-524-1981
Mailing Address - Street 1:133 PEACHTREE ST NE
Mailing Address - Street 2:SUITE 4050
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303-1804
Mailing Address - Country:US
Mailing Address - Phone:404-524-1981
Mailing Address - Fax:404-524-8463
Practice Address - Street 1:133 PEACHTREE ST NE
Practice Address - Street 2:SUITE 4050
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-1804
Practice Address - Country:US
Practice Address - Phone:404-524-1981
Practice Address - Fax:404-524-8463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA86791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1851440093OtherDENTAL INSURANCE AND MEDICAL INSURANCE