| NPI | 1114132115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT A FOSTER President 770-971-5119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: GA 0007966) |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2020-08-22 |