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NPI Code Detail

MEDICARE: OAKWOOD SMILES PC

MEDICARE: OAKWOOD SMILES PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryDN013149GA

General Provider Information

NPI Number : 1770724619
Entity Type Code : Organization
Provider Name (Legal Business Name) : OAKWOOD SMILES PC
Provider Business Mailing Address
First Line : PO BOX 19
Second Line :
City : OAKWOOD
State : GA
Zip : 30566-0001
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4038 MUNDY MILL RD
Second Line :
City : OAKWOOD
State : GA
Zip : 30566-2518
Country : US
Telephone Number : 770-534-4292
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : SERGEY GRITSIV
Credential :
Telephone Number : 770-534-4292
Provider Enumeration Date : 03/23/2009
Last Update Date : 12/07/2012

Similar Medicare Providers

1104893742 — SERGEY VALERIEYVICH GRITSIV DMD
Practice Location Address:
4038 MUNDY MILL RD
OAKWOOD, GA
30566-2518
Practice Phone: 770-534-4292
Practice Fax:
1356360051 — DR. MICHAEL KIM MARTIN DDS
Practice Location Address:
4328 MUNDY MILL RD
OAKWOOD, GA
30566-2518
Practice Phone: 770-534-3350
Practice Fax:
1699889857 — S GRITSIV DMD PC
Practice Location Address:
4328 MUNDY MILL RD
OAKWOOD, GA
30566-2518
Practice Phone: 770-534-4292
Practice Fax:
1295126092 — MR. BENJAMIN MARTIN
Practice Location Address:
4328 MUNDY MILL RD
OAKWOOD, GA
30566-2518
Practice Phone: 770-534-3350
Practice Fax:
1689147522 — MUNDY MILL DENTAL, PC
Practice Location Address:
4328 MUNDY MILL RD
OAKWOOD, GA
30566-2518
Practice Phone: 770-534-3350
Practice Fax: 770-534-5718
1225501190 — BENJAMIN MARTIN DMD PC
Practice Location Address:
4328 MUNDY MILL RD
OAKWOOD, GA
30566-2518
Practice Phone: 770-534-3350
Practice Fax: 770-534-5718

Directions to “OAKWOOD SMILES PC ” Practice Location

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