| NPI | 1073056933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VISHANT NATH Dentist 770-651-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: GA DN013057) |
| Enumeration Date | 2016-11-28 |
| Last Update Date | 2016-11-28 |