Provider Demographics
NPI:1407214752
Name:ZOHRABYAN, GEORGI (DMD)
Entity Type:Individual
Prefix:DR
First Name:GEORGI
Middle Name:
Last Name:ZOHRABYAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 SPRING RIDGE TRCE
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-2647
Mailing Address - Country:US
Mailing Address - Phone:770-366-7903
Mailing Address - Fax:
Practice Address - Street 1:270 SPRING RIDGE TRCE
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-2647
Practice Address - Country:US
Practice Address - Phone:770-366-7903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-02
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN015039122300000X
MADN1857137122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist