| NPI | 1063947182 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ALLEN BENS Owner 770-913-0703 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 012194) |
| Enumeration Date | 2017-04-26 |
| Last Update Date | 2025-11-11 |