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Organization
NEWTOWN FAMILY DENTAL PC
Active
Organization
NEWTOWN FAMILY DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALIM J GRANT SR. DDS (OWNER/DENTIST)
(678) 571-6984
Entity
Organization
Contact information
Practice address
3280 OLD ALABAMA RD, SUITE 200, JOHNS CREEK, GA 30022-8544
(404) 437-7331
(404) 437-7599
Mailing address
3280 OLD ALABAMA RD, SUITE 200, JOHNS CREEK, GA 30022-8544
(404) 437-7331
(404) 437-7599
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN012743
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3481511
UNITED CONCORDIA
GA
05
—
904873006E
—
GA
Enumeration date
04/28/2017
Last updated
04/28/2017
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