| NPI | 1083805386 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODDIE AMOS CROUCH President Owner 770-977-9090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 8484) |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2007-08-05 |