| NPI | 1003366147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA SEBASTIAN Billing/Insurance Manager 770-479-9999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: GA DN013543) |
| Enumeration Date | 2016-10-13 |
| Last Update Date | 2017-03-08 |