| NPI | 1598052706 |
|---|---|
| Doing Business As | GRASSROOTS MEDICAL, GRASSROOTS DENTAL |
| Entity Type | Organization |
| Authorized Contact | DAVID G ATEN Chairmen Of The Board 678-398-6548 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 122300000X Dentist |
| 1223G0001X Dentist, General Practice | |
| 124Q00000X Dental Hygienist | |
| 126800000X Dental Assistant | |
| 207Q00000X Family Medicine | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| Enumeration Date | 2011-07-08 |
| Last Update Date | 2015-06-30 |