| NPI | 1083730824 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY H. ELROD President 770-921-6001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 10678) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2020-08-22 |