Organization
OAKWOOD SMILES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SERGEY GRITSIV (PRESIDENT)
(770) 534-4292
Entity
Organization
Contact information
Practice address
4038 MUNDY MILL RD, OAKWOOD, GA 30566-2518
(770) 534-4292
Mailing address
PO BOX 19, OAKWOOD, GA 30566-0001
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN013149
GA
Other
Enumeration date
03/23/2009
Last updated
12/07/2012
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