Provider Demographics
NPI:1548088081
Name:GRIN & COMPANY PEDIATRIC DENTISTRY LLC
Entity type:Organization
Organization Name:GRIN & COMPANY PEDIATRIC DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:BOYLES
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:678-414-8472
Mailing Address - Street 1:6108 SIMONE ST
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-1255
Mailing Address - Country:US
Mailing Address - Phone:678-414-8472
Mailing Address - Fax:
Practice Address - Street 1:954 SEVEN HILLS CONNECTOR RD
Practice Address - Street 2:SUITE 108
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101
Practice Address - Country:US
Practice Address - Phone:770-615-8040
Practice Address - Fax:770-615-6515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty