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1295806461
KENNETH ROBERT WYATT
CUMMING, GA
NPI
1295806461
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: GA 012032)
Enumeration Date
2006-11-10
Last Update Date
2014-06-11
Business Address
Dr. KENNETH ROBERT WYATT DMD
285 ELM ST SUITE 200
CUMMING, GA 30040-8233
Phone number: 770-887-2915
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Mailing Address
Dr. KENNETH ROBERT WYATT DMD
9020 CHAMPION CT
BALL GROUND, GA 30107-7018
Phone number: 770-888-3072
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