| Walter A Grage Dds Pc | |
|
4324 Covington Hwy Decatur GA 30035 | |
| (404) 289-6454 | |
| (404) 289-2570 |
| Full Name | Walter A Grage Dds Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4324 Covington Hwy, Decatur, Georgia |
| Authorized Official Name and Position | Walter A Grage (PRESIDENT) |
| Authorized Official Contact | 4042896454 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Walter A Grage Dds Pc 4324 Covington Hwy Decatur GA 30035 Ph: (404) 289-6454 | Walter A Grage Dds Pc 4324 Covington Hwy Decatur GA 30035 Ph: (404) 289-6454 |
| NPI Number | 1538255971 |
|---|---|
| Provider Enumeration Date | 10/05/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538255971 | NPI | - | NPPES |
| 00046175B | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 6216 (Georgia) | Primary |
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