Provider Demographics
NPI:1801083415
Name:GRIFFITH, ZOE SIMONE (DMD)
Entity type:Individual
Prefix:DR
First Name:ZOE
Middle Name:SIMONE
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2802 CLEARWATER TER SE
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30013-2484
Mailing Address - Country:US
Mailing Address - Phone:205-516-0231
Mailing Address - Fax:
Practice Address - Street 1:2802 CLEARWATER TER SE
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30013-2484
Practice Address - Country:US
Practice Address - Phone:470-595-3579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-27
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0136401223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice