Provider Demographics
NPI:1851440093
Name:KAUFFMAN, THOMAS W (DDS)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:W
Last Name:KAUFFMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
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
Practice Address - Country:US
Practice Address - Phone:404-524-1981
Practice Address - Fax:404-524-8463
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA86791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice