| NPI | 1053673491 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK B TOMS Owner 770-536-4471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: GA DN011574) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2012-06-12 |