| NPI | 1114064086 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN C MARTIN Orthodontist 678-963-9888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: GA 008367) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2020-08-22 |