| NPI | 1104924976 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | BRIAN JOHN DOWD VP 770-446-8000  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics | 
| Additional Taxonomies | 1223G0001X Dentist, General Practice | 
| 1223P0300X Dentist, Periodontics | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| Enumeration Date | 2006-09-20 | 
| Last Update Date | 2025-09-11 |