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MODERN COSMETIC DENTAL CARE, LLC
NPI 1992103428
Clinic/Center - Dental in Covington, GA

Active since December 16, 2014
1750 HIGHWAY 11, SUITE B, COVINGTON, GA 30014(678) 592-1125 Get Directions Write a Review

NPPES record last updated: December 16, 2014. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Modern Cosmetic Dental Care, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MODERN COSMETIC DENTAL CARE, LLC (NPI 1992103428) is a healthcare organization registered as a dental in Covington, Georgia and active in the NPI registry since December 2014. The organization lists Tom Mazzuckelli, Manager, as its authorized official.

NPPES Registry Identity

NPI1992103428
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameMODERN COSMETIC DENTAL CARE, LLC
Location Address1750 HIGHWAY 11, SUITE BCovington, GA 30014
Mailing Address1750 Highway 11, Suite BCovington, GA 30014 · (678) 592-1125
Phone(678) 592-1125
Organization SubpartNo
Authorized OfficialTom MazzuckelliManager · (678) 592-1125
Enumeration DateDecember 16, 2014
✔ NPI 1992103428 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
License✔ Licensed in GA · DN011417
1750 HIGHWAY 11, Covington, GA 30014
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Modern Cosmetic Dental Care, LLC's NPI number?

The NPI number for Modern Cosmetic Dental Care, LLC is 1992103428. It was assigned to this organization in the NPPES registry on December 16, 2014.

Where is Modern Cosmetic Dental Care, LLC located?

Modern Cosmetic Dental Care, LLC is located at 1750 Highway 11 Suite B, Covington, GA 30014. The listed phone number is (678) 592-1125.

What is Modern Cosmetic Dental Care, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

When was this NPI record last updated?

The NPPES record for Modern Cosmetic Dental Care, LLC was last updated on December 16, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.