Individual
DR. GREGG R CODELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1707A MOUNT VERNON RD, ATLANTA, GA 30338-4207
(770) 668-0604
(770) 234-4065
Mailing address
3941 GLENNCREST CT NE, ATLANTA, GA 30319-1893
(770) 668-0604
(770) 234-4065
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
10306
GA
Other
Enumeration date
01/20/2007
Last updated
07/08/2007
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