| NPI | 1003968496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA SIMS Office Manager 770-439-2550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN012710) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2011-10-06 |