Provider Demographics
NPI:1699120709
Name:CUMMINGS, RACHEL MARIE (DDS)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:MARIE
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 17TH AVE S
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-3905
Mailing Address - Country:US
Mailing Address - Phone:701-775-0641
Mailing Address - Fax:701-746-9328
Practice Address - Street 1:4000 17TH AVE S
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201
Practice Address - Country:US
Practice Address - Phone:701-775-0641
Practice Address - Fax:701-746-9328
Is Sole Proprietor?:No
Enumeration Date:2016-04-26
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND22841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice