Provider Demographics
NPI:1508085234
Name:DONEFF, GREGORY SCOTT (DDS)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:SCOTT
Last Name:DONEFF
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3166 HUDSON POND LN
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-6697
Mailing Address - Country:US
Mailing Address - Phone:770-579-8681
Mailing Address - Fax:
Practice Address - Street 1:200 ASHFORD CTR N
Practice Address - Street 2:SUITE 330
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-2668
Practice Address - Country:US
Practice Address - Phone:770-396-1188
Practice Address - Fax:770-396-6055
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN013356122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist