| NPI | 1003123563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VISHANT NATH Owner 678-763-2600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA dn 13057) |
| Enumeration Date | 2010-09-07 |
| Last Update Date | 2010-09-07 |