| NPI | 1003212259 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANETTE M YOUNG Owner/Dentist 678-355-0222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN014390) |
| Enumeration Date | 2014-11-17 |
| Last Update Date | 2014-11-17 |