NPI | 1063929487 |
---|---|
Entity Type | Organization |
Authorized Contact | TAMONIA LEONARD Credentialing Specialist 678-244-4844 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
Enumeration Date | 2018-01-08 |
Last Update Date | 2018-01-08 |