Chastain Dental Group LLC
Clinic/Center, Dental in Atlanta, GA. Organization (NPI-2).
NPI number1245041979
StatusActive
Last updated in NPPESJan 14, 2025
Details
- NPI
- 1245041979
- Entity type
- Organization (NPI-2)
- Legal business name
- Chastain Dental Group LLC
- Organization subpart
- No
- Enumeration date
- Jan 14, 2025
- Certification date
- Jan 14, 2025
- Last updated
- Jan 14, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | – | – | Yes |
Other names
- Grin Gallery Pediatric Dentistry (Doing Business As)
Practice location
4920 Roswell Rd Ste 265Atlanta, GA 30342-2686
Phone 404-458-9908 · Fax 404-458-9905
Mailing address
3921 Obryant Cir SeSmyrna, GA 30082-3906
Phone 404-512-1889
Authorized official
Donielle Williams
Pediatric Dentist / Owner
4044589908
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