| NPI | 1023347937 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRAD J HARRIS Sole Member/Oral Surgeon 678-350-6566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: GA DNO12915) |
| Enumeration Date | 2009-12-24 |
| Last Update Date | 2009-12-24 |