| NPI | 1093563751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIANNA KOVITCH Dentist/Owner 770-615-6510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2024-05-08 |
| Last Update Date | 2024-09-25 |