Organization
BUCKHEAD SMILES COSMETIC AND FAMILY DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PORTIA MAXINE GRAYSON DDS (OWNER DENTIST)
(404) 917-1111
Entity
Organization
Contact information
Practice address
321 PHARR RD NE, SUITE A, ATLANTA, GA 30305-2346
(404) 917-1111
(404) 917-1113
Mailing address
321 PHARR RD NE, SUITE A, ATLANTA, GA 30305-2346
(404) 917-1111
(404) 917-1113
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN012800
GA
Other
Enumeration date
03/06/2007
Last updated
08/22/2020
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