| NPI | 1003999368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN JOHN DOWD VP 770-446-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics |
| 1223P0700X Dentist, Prosthodontics | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2020-08-22 |