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Organization
COMMUNITY HEALTH CENTER, INC.
Active
Organization
COMMUNITY HEALTH CENTER, INC.
Active
Other names
Grassroots Medical, Grassroots Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID G ATEN (CHAIRMEN OF THE BOARD)
(678) 398-6548
Entity
Organization
Contact information
Practice address
4485 N TOWN SQ, SUITE 108, POWDER SPRINGS, GA 30127-2242
(678) 398-6548
Mailing address
PO BOX 340, POWDER SPRINGS, GA 30127-0340
(678) 398-6548
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
—
—
124Q00000X
Dental Hygienist
—
—
126800000X
Dental Assistant
—
—
207Q00000X
Family Medicine Physician
—
—
2083P0901X
Public Health & General Preventive Medicine Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003141372A
—
GA
Enumeration date
07/08/2011
Last updated
06/30/2015
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