| NPI | 1053595298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AKIN JAWANDO Regional Clinical Coordinator 678-387-2783 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN011529) |
| Enumeration Date | 2007-12-24 |
| Last Update Date | 2014-05-20 |