Organization
GRANT PARK DENTAL GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHISH PRAVIN VAKHARIA DMD (PRESIDENT)
(412) 716-7907
Entity
Organization
Contact information
Practice address
465 BOULEVARD SE STE 207A, ATLANTA, GA 30312-3483
(404) 624-1230
(404) 624-1210
Mailing address
465 BOULEVARD SE STE 207A, ATLANTA, GA 30312-3483
(404) 624-1230
(404) 624-1210
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DN012466
GA
1223G0001X
General Practice Dentistry
Primary
DN013218
GA
Other
Enumeration date
12/28/2010
Last updated
12/28/2010
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