| NPI | 1053720466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIGUEL HERNANDEZ Owner 770-248-9059 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2014-08-11 |
| Last Update Date | 2014-08-11 |