Healthcare Provider Details

I. General information

NPI: 1831000884
Provider Name (Legal Business Name): GRAYSON DENTAL ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2340 LONGANVILLE HWY SUITE A102
GRAYSON GA
30017
US

IV. Provider business mailing address

2340 LONGANVILLE HWY SUITE A102
GRAYSON GA
30017
US

V. Phone/Fax

Practice location:
  • Phone: 770-513-0046
  • Fax: 770-513-3391
Mailing address:
  • Phone: 770-513-0046
  • Fax: 770-513-3391

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: MR. ASHF TAUFIA
Title or Position: OWNER
Credential: DDS, MBA
Phone: 770-962-0515