Healthcare Provider Details

I. General information

NPI: 1508780065
Provider Name (Legal Business Name): GRINS AND GIGGLES PEDIATRIC DENTISTRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 CURTIS PKWY NE STE B
CALHOUN GA
30701-2057
US

IV. Provider business mailing address

190 CURTIS PKWY NE STE B
CALHOUN GA
30701-2057
US

V. Phone/Fax

Practice location:
  • Phone: 706-602-0448
  • Fax:
Mailing address:
  • Phone: 706-602-0448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: TONYA BAKER
Title or Position: OWNER
Credential: DMD
Phone: 706-602-0448