Organization
ENW DENTISTRY PC DBA
Active
Other names
Zoom Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EUGENE N WITKIN DDS (DDS/OWNER)
(770) 751-8887
Entity
Organization
Contact information
Practice address
207 SW UPPER RIVERDALE ROAD, RIVERDALE, GA 30274-2537
(770) 751-8887
Mailing address
207 UPPER RIVERDALE RD SW, RIVERDALE, GA 30274-2537
(770) 751-8887
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
009491
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00969724E
—
GA
Enumeration date
09/12/2006
Last updated
08/22/2020
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