| NPI | 1073879193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN M OWENS Dentist Owner Of Practice 770-382-0330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DND13878) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA 7651) |
| Enumeration Date | 2012-04-03 |
| Last Update Date | 2012-04-03 |