| NPI | 1003124066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BROCK BUCHANAN WESTOVER Owner/Dentist 770-455-6076 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN013457) |
| Enumeration Date | 2010-09-23 |
| Last Update Date | 2010-09-23 |