| NPI | 1073979837 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES BROWN Memeber 770-623-1198 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN010208) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA DN015111) |
| Enumeration Date | 2016-01-10 |
| Last Update Date | 2016-01-10 |