| NPI | 1063651511 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATASHIA HOLMES Dentist 770-503-7130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN012868) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA DN013188) |
| Enumeration Date | 2009-02-06 |
| Last Update Date | 2009-02-06 |