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 |