| NPI | 1104248137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLISE M CALLOWAY Owner/Orthodontist 678-418-3000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: GA 012709) |
| Enumeration Date | 2014-01-10 |
| Last Update Date | 2014-01-10 |