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General NPI Number Information
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NPI Number | 1508085234
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Entity Type | Individual
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Provider Name | GREGORY SCOTT DONEFF D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 200 ASHFORD CTR N SUITE 330
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City | DUNWOODY
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State | GA
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Zip | 30338-2668
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Country | US
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Telephone | 770-396-1188
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Fax | 770-396-6055
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Provider Business Mailing Address
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Address Line | 3166 HUDSON POND LN
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City | MARIETTA
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State | GA
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Zip | 30062-6697
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Country | US
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Telephone | 770-579-8681
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN013356
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License Number State | GA
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