| NPI | 1013121359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD G. BENNETT Owner 770-532-4555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN011850) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2011-10-19 |