Provider Demographics
NPI:1659547529
Name:CUMMINS, CAROL M (DDS)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:M
Last Name:CUMMINS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:M
Other - Last Name:CUMMINS-KOLINSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:3708 RIDGE POINTE DR
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-5104
Mailing Address - Country:US
Mailing Address - Phone:630-232-4746
Mailing Address - Fax:
Practice Address - Street 1:3708 RIDGE POINTE DR
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-5104
Practice Address - Country:US
Practice Address - Phone:630-232-4746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019017221122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist