Organization
DG DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVAN GRODIN DMD (CEO)
(770) 851-8383
Entity
Organization
Contact information
Practice address
3280 HOWELL MILL RD NW STE 327, ATLANTA, GA 30327-4109
(470) 451-0981
(470) 451-0982
Mailing address
1101 JUNIPER ST NE APT 707, ATLANTA, GA 30309-7659
(770) 851-8383
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
1223P0700X
Prosthodontics
—
—
Other
Enumeration date
09/27/2021
Last updated
09/27/2021
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