James L. Cannon, DDS,MS

Individual provider Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · Clermont, GA

NPI 1255466702 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1255466702
Entity type
Individual (NPI type 1)
Primary specialty
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
License
6721 (GA)
Practice address
5297 Cleveland Hwy
Clermont, GA 30527-2205
Phone
(770) 983-7633
Fax
(770) 983-7884
NPI assigned
Feb 23, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Master of Science

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 6721 GA Yes

Addresses

Primary practice location

5297 Cleveland Hwy
Clermont, GA 30527-2205

Mailing address

5297 Cleveland Hwy
Clermont, GA 30527-2205
Phone (770) 983-7633

Other providers in Clermont, GA

All providers in Clermont, GA · Orthodontics and Dentofacial Orthopedics Dentistry in Georgia

Sources for this page

Verify at the official NPI Registry.