| NPI | 1013218106 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDY HOFFMAN Credential Assistant 678-756-5921 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 20487) |
| Enumeration Date | 2010-11-05 |
| Last Update Date | 2023-01-31 |