Individual
SERGEY VALERIEYVICH GRITSIV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4038 MUNDY MILL RD, OAKWOOD, GA 30566-2518
(770) 534-4292
Mailing address
PO BOX 19, OAKWOOD, GA 30566-0001
(770) 534-4292
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN013149
GA
Other
Enumeration date
03/02/2006
Last updated
12/07/2012
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