Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Modern Cosmetic Dental Care, LLC

Organization Dental Clinic/Center · NPI 1992103428

Modern Cosmetic Dental Care, LLC is a Dental Clinic/Center in Covington, Georgia. Licensed in Georgia. Registered with an NPI since 2014.

Licensed in
GA
In the registry since
2014
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1750 Highway 11 Ste B
Covington, GA 30014
Phone: (678) 592-1125
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dental Clinic/Center (primary) Taxonomy 261QD0000X · Licence DN011417 (GA)

Record details

NPI number1992103428
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tom Mazzuckelli — Manager · (678) 592-1125
NPI enumeratedDecember 16, 2014
Last updated in NPPESDecember 16, 2014
Mailing address1750 Highway 11, Suite B, Covington, GA 30014

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