Healthcare Provider Details

I. General information

NPI: 1346155850
Provider Name (Legal Business Name): GRAYSON SMILES & IMPLANTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1075 COOPER RD STE 101
GRAYSON GA
30017-4268
US

IV. Provider business mailing address

1075 COOPER RD STE 101
GRAYSON GA
30017-4268
US

V. Phone/Fax

Practice location:
  • Phone: 470-474-2256
  • Fax:
Mailing address:
  • Phone: 470-474-2256
  • 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: DR. TWISHA PATEL
Title or Position: OWNER
Credential: DMD
Phone: 843-333-1238