| NPI | 1114145158 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAGE P. BARDEN President 404-272-2512 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: GA DN0010757) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2020-08-22 |