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Individual

DR. GIA S. GRANNUM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
5185 PEACHTREE PKWY STE 325, PEACHTREE CORNERS, GA 30092-6541
(678) 831-5437
Mailing address
5185 PEACHTREE PKWY STE 325, PEACHTREE CORNERS, GA 30092-6541
(678) 831-5437
(678) 831-5462

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
25502
TX
1223P0221X
Pediatric Dentistry
25502
TX
1223P0221X
Pediatric Dentistry
Primary
DN013924
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003121519
GA
Enumeration date
07/21/2008
Last updated
09/03/2024
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