| NPI | 1063471324 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY P. MARKS President 404-233-8221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: GA 010603) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2016-11-15 |