| NPI | 1114075538 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARSHA A GORDON President 770-452-7358 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN008988) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2018-04-13 |