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 |