Organization
GEORGIA SMILE TEAM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EUGENE WITKIN DDS (OWNER)
(770) 536-3254
Entity
Organization
Contact information
Practice address
578 S ENOTA DR NE, GAINESVILLE, GA 30501-8947
(770) 536-3254
Mailing address
578 S ENOTA DR NE, GAINESVILLE, GA 30501-8947
(770) 536-3254
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN009491
GA
Other
Enumeration date
10/02/2012
Last updated
10/02/2012
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