| NPI | 1023149507 |
|---|---|
| Doing Business As | DENTISTRY OF OLDE TOWNE |
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER LEE RAUTENSTRAUCH Owner LLC Member 770-928-3055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN012537) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA 9445) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2020-08-22 |