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Grayson Pediatric Dentistry, P.c.

NPI #1598067993 in Grayson, Georgia

Provider Information

NPI Number
1598067993
Entity Type
Organization
Organization Name
Grayson Pediatric Dentistry, P.c.
Primary Specialty
Dentist - Pediatric Dentistry
Enumeration Date
Nov 17, 2010
Last Updated
Nov 17, 2010

Practice Location

Address
2594 LOGANVILLE HWY
Address 2
SUITE 106
City
Grayson
State
Georgia
ZIP Code
30017-7848
Phone
(678) 682-9819

Authorized Official

Name
DR. ASHA YAMINI PONUGOTI, D.D.S.
Title
OWNER
Phone
(678) 613-5095

Specialties & Taxonomy Codes

Specialty
Dentist - Pediatric Dentistry — Pediatric Dentistry

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