| NPI | 1003291329 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAMIAN L SOMMERVILLE Owner 770-423-0324 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN014899) |
| Enumeration Date | 2015-07-28 |
| Last Update Date | 2016-03-29 |