| NPI | 1073743795 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUES LEONEL GORDON President 404-629-6610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: GA DN013463) |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2009-07-15 |